scholarly journals Three-hour post-ERCP amylase level: a useful indicator for early prediction of post-ERCP pancreatitis

2020 ◽  
Author(s):  
Ze-Hui Lv ◽  
Da-Qing Kou ◽  
Shi-Bin Guo
Keyword(s):  
Confidence Interval ◽  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Predictive Value ◽  
Serum Amylase ◽  
Roc Curves ◽  
Amylase Level ◽  
Early Prediction ◽  
Serum Amylase Level ◽  
Significant Difference

Abstract Background: To evaluate the value of the 3-hour post-ERCP serum amylase level for early prediction of post-ERCP pancreatitis (PEP). Method: A study of 206 patients performed ERCP was analysed. The patients with PEP were recorded. ROC curves were used to statistically analyze the data. Results: PEP occurred in 21 patients (10.19%). The 3-hour post-ERCP pancreatic amylase level was used as the test variable, and the PEP occurrence as the state variable to plot ROC curve. The area under the curve (AUC) was 0.816 , and was statistically significant (P<0.001). The standard error (SE) was 0.0507, the 95% confidence interval (CI) was 0.756-0.866, and the optimal cut-off value was 351U/L (sensitivity 76.19%, specificity 83.24%, positive likelihood ratio 4.55, negative likelihood ratio 0.29, Youden index 59.43%). The ROC curves were plotted for both serum amylase and lipase respectively. The areas under the ROC curves were statistically significant(P<0.001). The area under the ROC curve for the 3-hour post-ERCP lipase was 0.778, the 95% confidence interval was 0.673-0.862, and optimal cut-off value was 1834 U/L. The area under the ROC curve for the 3-hour post-ERCP serum amylase was 0.780, and the 95% confidence interval was 0.676-0.864. The optimal cut-off is 380U/L, and there was no statistically significant difference between the two for diagnostic accuracy. According to gender, there was no statistically significant difference in the diagnostic accuracy. In the male group, 436 U/L serum amylase provided the greatest diagnostic accuracy with sensitivity(SE) of 70.5%, specificity(SP) of 89.2%, positive predictive value (PPV) 87.5%, and negative predictive value (NPV) 78.1%. Whereas, in the female group, 357U/L serum amylase provided the greatest diagnostic accuracy with sensitivity of 76.9%, specificity of 81.2%, positive predictive value of 80.4%, negative predictive value of 77.9%. Conclusions: 1. The 3-hour post-ERCP serum amylase level is a useful measurement for predicting post-ERCP pancreatitis. 2. There was no significant difference between serum amylase and lipase 3-hour post-ERCP for predicting PEP. 3. There was no statistically significant difference between male and female using the 3-hour post-ERCP serum amylase level to predict PEP. For female, the optimal cut-off value was 357 U/L, whereas male 436U/L .

scholarly journals Three-hour post-ERCP amylase level: a useful indicator for early prediction of post-ERCP pancreatitis

2020 ◽  
Author(s):  
Ze-Hui Lv ◽  
Da-Qing Kou ◽  
Shi-Bin Guo
Keyword(s):  
Confidence Interval ◽  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Predictive Value ◽  
Serum Amylase ◽  
Roc Curves ◽  
Amylase Level ◽  
Early Prediction ◽  
Serum Amylase Level ◽  
Significant Difference

Abstract Background : To evaluate the value of the 3-hour post-ERCP serum amylase level for early prediction of post-ERCP pancreatitis (PEP). Method: A study of 206 patients performed ERCP was analysed. The patients with PEP were recorded. ROC curves were used to statistically analyze the data. Results : PEP occurred in 21 patients (10.19%). The 3-hour post-ERCP pancreatic amylase level was used as the test variable, and the PEP occurrence as the state variable to plot ROC curve. The area under the curve (AUC) was 0.816 , and was statistically significant (P<0.001). The standard error (SE) was 0.0507, the 95% confidence interval (CI) was 0.756-0.866, and the optimal cut-off value was 351U/L (sensitivity 76.19%, specificity 83.24%, positive likelihood ratio 4.55, negative likelihood ratio 0.29, Youden index 59.43%). The ROC curves were plotted for both serum amylase and lipase respectively. The areas under the ROC curves were statistically significant(P<0.001). The area under the ROC curve for the 3-hour post-ERCP lipase was 0.778, the 95% confidence interval was 0.673-0.862, and optimal cut-off value was 1834 U/L. The area under the ROC curve for the 3-hour post-ERCP serum amylase was 0.780, and the 95% confidence interval was 0.676-0.864. The optimal cut-off is 380U/L, and there was no statistically significant difference between the two for diagnostic accuracy. According to gender, there was no statistically significant difference in the diagnostic accuracy. In the male group, 436 U/L serum amylase provided the greatest diagnostic accuracy with sensitivity(SE) of 70.5%, specificity(SP) of 89.2%, positive predictive value (PPV) 87.5%, and negative predictive value (NPV) 78.1%. Whereas, in the female group, 357U/L serum amylase provided the greatest diagnostic accuracy with sensitivity of 76.9%, specificity of 81.2%, positive predictive value of 80.4%, negative predictive value of 77.9%. Conclusions: 1. The 3-hour post-ERCP serum amylase level is a useful measurement for predicting post-ERCP pancreatitis. 2. There was no significant difference between serum amylase and lipase 3-hour post-ERCP for predicting PEP. 3. There was no statistically significant difference between male and female using the 3-hour post-ERCP serum amylase level to predict PEP.

scholarly journals Three-hour post-ERCP amylase level: a useful indicator for early prediction of PEP

2019 ◽  
Author(s):  
Ze-Hui Lv ◽  
Da-Qing Kou ◽  
Shi-Bin Guo
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Roc Curve ◽  
Predictive Value ◽  
Serum Amylase ◽  
Amylase Level ◽  
Early Prediction ◽  
Serum Amylase Level ◽  
Significant Difference

Abstract Background : To evaluate the value of the 3-hour post-ERCP serum amylase level for early prediction of post-ERCP pancreatitis (PEP). Method: A study of 206 patients performed ERCP at a single centre was collected from 2011 to 2016. The serum amylase or lipase level was measured at 3 h after ERCP. The patients with PEP were recorded. ROC curves were used to statistically analyze the data: The enrolled patients were divided into two groups according to gender, then be analyzed respectively. We comprehensively evaluated the predictive value of PEP by serum amylase level 3-hour post-ERCP based on the results above. Results : In the 206 patients, the 3-hour post-ERCP pancreatic amylase level was used as the test variable, and the PEP occurrence as the state variable to plot the ROC curve. The optimal cut-off value was 351U/L (sensitivity 76.19%, specificity 83.24%, positive likelihood ratio 4.55, negative likelihood ratio 0.29, Youden index 59.43%). There were 83 patients with both 3-hour post-ERCP amylase level and lipase level detected. The area under the ROC curve for the 3-hour post-ERCP serum amylase was 0.780, and the 95% confidence interval was 0.676-0.864. The optimal cut-off is 380U/L, and there was no statistically significant difference between the two for diagnostic accuracy. According to gender, there was no statistically significant difference in the diagnostic accuracy of the two groups. In the male group, 436 U/L serum amylase provided the greatest diagnostic accuracy with sensitivity(SE) of 70.5%, specificity(SP) of 89.2%, positive predictive value (PPV) 87.5%, and negative predictive value (NPV) 78.1%. Whereas, in the female group, 357U/L serum amylase provided the greatest diagnostic accuracy with sensitivity of 76.9%, specificity of 81.2%, positive predictive value of 80.4%, negative predictive value of 77.9%. Conclusions: 1. The 3-hour post-ERCP serum amylase level is a useful measurement for predicting post-ERCP pancreatitis. 2. There was no significant difference between serum amylase and lipase 3-hour post-ERCP for predicting PEP. 3. There was no statistically significant difference between male and female using the 3-hour post-ERCP serum amylase level to prediction PEP . For female, the optimal cut-off value was 357 U/L, whereas male 436U/L .

scholarly journals Predictive value of serum amylase level in outcome of multiple trauma patients

2016 ◽  
Vol 4 (2) ◽  
pp. 115-121
Author(s):  
Arezu Nejabatian ◽  
Farzad Rahmani ◽  
Rozbeh Rajaei Ghafori ◽  
Samad Shams Vahdati ◽  
Parizad Varghayi ◽  
...  
Keyword(s):  
Multiple Trauma ◽  
Predictive Value ◽  
Serum Amylase ◽  
Amylase Level ◽  
Trauma Patients ◽  
Serum Amylase Level ◽  
Multiple Trauma Patients

Predictive value of time-variant color-coded multiphase CT angiography (mCTA) regarding clinical outcome of acute ischemic stroke: in comparison with conventional mCTA and CT perfusion

2020 ◽  
pp. 028418512098177
Author(s):  
Yu Lin ◽  
Nannan Kang ◽  
Jianghe Kang ◽  
Shaomao Lv ◽  
Jinan Wang
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Predictive Value ◽  
Ct Perfusion ◽  
Roc Curves ◽  
Multivariate Logistic Regression Model ◽  
Infarct Core ◽  
Predictive Values ◽  
Significant Difference ◽  
Core Volume

Background Color-coded multiphase computed tomography angiography (mCTA) can provide time-variant blood flow information of collateral circulation for acute ischemic stroke (AIS). Purpose To compare the predictive values of color-coded mCTA, conventional mCTA, and CT perfusion (CTP) for the clinical outcomes of patients with AIS. Material and Methods Consecutive patients with anterior circulation AIS were retrospectively reviewed at our center. Baseline collateral scores of color-coded mCTA and conventional mCTA were assessed by a 6-point scale. The reliabilities between junior and senior observers were assessed by weighted Kappa coefficients. Receiver operating characteristic (ROC) curves and multivariate logistic regression model were applied to evaluate the predictive capabilities of color-coded mCTA and conventional mCTA scores, and CTP parameters (hypoperfusion and infarct core volume) for a favorable outcome of AIS. Results A total of 138 patients (including 70 cases of good outcomes) were included in our study. Patients with favorable prognoses were correlated with better collateral circulations on both color-coded and conventional mCTA, and smaller hypoperfusion and infarct core volume (all P < 0.05) on CTP. ROC curves revealed no significant difference between the predictive capability of color-coded and conventional mCTA ( P = 0.427). The predictive value of CTP parameters tended to be inferior to that of color-coded mCTA score (all P < 0.001). Both junior and senior observers had consistently excellent performances (κ = 0.89) when analyzing color-coded mCTA maps. Conclusion Color-coded mCTA provides prognostic information of patients with AIS equivalent to or better than that of conventional mCTA and CTP. Junior radiologists can reach high diagnostic accuracy when interpreting color-coded mCTA images.

scholarly journals Role of Liver Enzymes in Patients with Blunt Abdominal Trauma to Diagnose Liver Injury

2020 ◽  
Author(s):  
Anup Shrestha ◽  
Harish Chandra Neupane ◽  
Kishor Kumar Tamrakar ◽  
Abhishek Bhattarai ◽  
Gaurav Katwal
Keyword(s):  
Liver Injury ◽  
Confidence Interval ◽  
Ct Scan ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Predictive Value ◽  
Liver Enzymes ◽  
Tertiary Center ◽  
Significant Difference

Abstract Background:The liver is the second most injured organ following blunt abdominal trauma (BAT) after spleen. Although the computed tomography (CT) scan is considered as the gold standard for diagnosing liver injury in BAT, it is not readily available in the hospital. This study was performed to evaluate the role of aspartate transaminase (AST) and alanine transaminase (ALT) in patients with BAT and its significance in predicting the diagnosis and severity of the liver injury.Method:The study was conducted in Chitwan Medical College Teaching Hospital (CMCTH) study from February 2019 to May 2020. During that period 96 patients with BAT presented to the emergency department(ED) of CMCTH.Results:Among the 96 patients admitted with BAT, 38 patients had liver injury and 58 patients had no liver injury. The median length of the intensive care unit (ICU) stay of patients with liver injury was higher than without liver injury. There was a significant difference in the median level of AST and ALT (<0.001) between patients with liver injury and no liver injury. The area under the ROC curve of AST was 0.89(95% Confidence Interval 0.86-0.98) and of ALT was 0.92(95% Confidence Interval 0.83-0.97). The area under the curve demonstrated that the test was a good predictor for the identification of liver injury and also the severity of liver enzymes. The cut-off values for the liver injury were 106 U/l and 80 U/l for AST and ALT respectively. Based on these values, AST ≥ 106 U/l had a sensitivity of 71.7 %, a specificity of 90 %, a positive predictive value of 86.8 %, and a negative predictive value of 77.6 %. The corresponding values for ALT ≥ 80 U/l were 77.8 %, 94.1%, 92.1% and 82.8 %, respectively.ConclusionIn conclusion, we report the optimal cut-off value of AST and ALT for liver injury in BAT as ≥ 106 U/l and 80 U/l respectively. The elevated level of AST and ALT might assist the surgeons to timely refer the suspected patients with the liver to a tertiary center and it might help the surgeons to go for conservative management for minor liver injuries in BAT preventing the exposure hazards of the CT scan.

scholarly journals Mid-arm and Chest Circumferences for Estimating Low Birthweight

2018 ◽  
Vol 33 (1-2) ◽  
pp. 24-31
Author(s):  
Achmad Surjono
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Low Birthweight ◽  
Newborn Infants ◽  
Roc Curves ◽  
Strong Correlations ◽  
Significant Difference ◽  
A Prospective Study

A prospective study was conducted to assess the diagnostic performance of mid-arm and chest circumferences on low birth weights in 1033 singleton newborn infants. The proportion of low birth weight was 11.7%. Strong correlations on birth weight (P<0.001) were found for mid-arm (r-0.85) and chest (r=0.86) circumferences. A mid-arm circumference of ≤9,5 cm was considered as cut-off level for low birth weight, with a sensitivity of 0.818, specificity 0.956 and positive predictive value 0. 712. Whereas that of chest circumference wa ≤29.5 cm with a sensitivity of 0. 785, specificity 0.895 and positive predictive value 0.497. Receiver operating characteristic (ROC) curves were used to compare their diagnostic accuracy. The area under these two ROC(± SE) were 0.954 ± 0.011 for mid-arm and 0.945 ± 0.012 for chest circumferences, respectively. Both areas showed significant differences with the area under chance line. No statistically significant difference was found between the area under ROC of mid-arm and chest circumferences. The results showed that mid-arm and chest circumferences as simple and reliable measurements can be used in estimating low birth weight, in areas where the accurate weighing of newborn infants is not feasible.

scholarly journals Arthralgia and Osteolytic Lesions Associated with Traumatic Pancreatitis in a 10-Year-Old Girl

2009 ◽  
Vol 2009 ◽  
pp. 1-3
Author(s):  
Masayuki Obatake ◽  
Yusuke Yamane ◽  
Takayuki Tokunaga ◽  
Yasuaki Taura ◽  
Yukio Inamura ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Joint Pain ◽  
Serum Amylase ◽  
Knee Joints ◽  
Pancreatic Pseudocysts ◽  
Amylase Level ◽  
Serum Amylase Level ◽  
Osteolytic Lesions ◽  
Pseudocyst Drainage ◽  
Traumatic Pancreatitis

A case of traumatic pancreatitis with subsequent joint pain and osteolytic lesions is presented. A 10-year-old girl was admitted to our hospital with abdominal pain caused by blunt epigastric injury. She was diagnosed with traumatic pancreatitis, and multiple pancreatic pseudocysts subsequently developed. Two weeks after admission, she complained of joint pain, and MR revealed osteolytic lesions of both knee joints. On the 58th day, endoscopic transgastric pseudocyst drainage was performed. Joint pain and osteolytic lesions resolved rapidly, in parallel with the decrease in serum amylase level and pseudocyst size.

scholarly journals Evaluation of quantitative fFn test in predicting the risk of preterm birth

2017 ◽  
Vol 45 (1) ◽  
Author(s):  
Michela Centra ◽  
Giuliana Coata ◽  
Elena Picchiassi ◽  
Luisa Alfonsi ◽  
Samanta Meniconi ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Predictive Value ◽  
Preterm Labour ◽  
Signs And Symptoms ◽  
Singleton Pregnancy ◽  
Fetal Fibronectin ◽  
Prediction Risk ◽  
Risk Categories

AbstractObjective:To evaluate diagnostic accuracy of quantitative fetal fibronectin (qfFN) test in predicting preterm birth (PTB) risk <34 weeks’ gestation or within 14 days from testing. We explored the predictive potential of the test in five-predefined PTB risk categories based on predefined qfFN thresholds (<10, 10–49, 50–199, 200–499 and ≥500 ng/mL).Methods:Measurement of cervicovaginal qfFN with Rapid fFN 10Q System (Hologic) in 126 women with singleton pregnancy (23–33 weeks’ gestation) reporting signs and symptoms indicative of preterm labour (PTL).Results:For PTB prediction risk <34 weeks’ gestation, sensitivity decreased from 100% to 41.7% and specificity increased from 0% to 99.1% with increasing fFN thresholds. Positive predictive value (PPV) increased from 9.5% to 83.3% with increasing qfFN thresholds, while negative predictive value (NPV) was higher than 90% among the fFN-predefined categories. Diagnostic accuracy results showed an area under a receiving operator characteristic (ROC) curve of 84.5% (95% CI, 0.770–0.903). For delivery prediction within 14 days from the testing, sensitivity decreased from 100% to 42.8% and specificity increased from 0% to 100% with increasing fFN thresholds. Diagnostic accuracy determined by the ROC curve was 66.1% (95% CI, 0.330–0.902).Conclusions:The QfFN thresholds of tests are a useful tool to distinguish pregnant women for PTB prediction risk <34 weeks’ gestation.

scholarly journals Combine preoperative estimation of serum thyroglobulin and ACR-thyroid imaging reporting and data system scoring could accurately define malignant thyroid nodules

2020 ◽  
Vol 8 (1) ◽  
pp. 32
Author(s):  
Waseem A. Shoda
Keyword(s):  
Roc Curve ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Curve Analysis ◽  
Data System ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Serum Thyroglobulin ◽  
Thyroid Imaging ◽  
Significant Difference

Background: Evaluation of diagnostic ability of preoperative estimation of serum thyroglobulin (TG) to detect malignant thyroid nodules (TN) in comparison to the American College of Radiology, Thyroid imaging reporting and data system (ACR-TIRADS), fine needle aspiration cytology (FNAC) and intraoperative frozen section (IO-FS).Methods: 34 patients with ACR-TIRADS 2-4 TN were evaluated preoperatively for identification of malignancy and all underwent total thyroidectomy with bilateral neck block dissection if indicated. Results of preoperative investigations were statistically analyzed using the Receiver operating characteristics (ROC) curve analysis as predictors for malignancy in comparison to postoperative paraffin sections.Results: Preoperative serum TG levels had 100% sensitivity and negative predictive value, while ACR-TIRADS scoring had 100% specificity and positive predictive value with accuracy rates of 95.35% and 97.67% for TG and TIRADS, respectively. ROC curve analysis defined preoperative ACR-TIRADS class and serum TG as highly diagnostic than FNAC for defining malignancy with non-significant difference between areas under curve for TIRADS and TG. For cases had intermediate risk of malignancy on TIRADS, IO-FS had missed 3, FNAC missed 4, while serum TG levels were very high in the 13 cases and were defined by ROC curve as the only significant predictor for malignancy.Conclusions: Preoperative estimation of serum TG showed higher diagnostic validity than FNAC, high predictability of cancer and ability to verify the intermediate findings on TIRADS. Combined preoperative TIRADS and TG estimation could accurately discriminate malignant TN with high accuracy and spare the need for preoperative FNAC or IO-FS. 

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