Ideal Predictors for the Severity of Acute Pancreatitis: A single center Egyptian study

Abstract

Background & Aims: The ideal predictor of acute pancreatitis should be inexpensive, readily available in most emergency departments, easily applicable, consistent, non-invasive and has the statistical power. Although such predictor has not been detected, the research continues to pursue such one. This survey was created to research and evaluate different simple laboratory tests as possible predictors of severe acute pancreatitis. Materials and Methods: The study population consists of 40 patients admitted to the gastroenterology and Hepatology unit, Tanta University emergency hospital after being diagnosed to have acute pancreatitis. The following data were collected from all patients within 24 hours of admission: Age, sex, complete blood count, body mass index, blood glucose level, serum creatinine, blood urea nitrogen, total bilirubin, aspartate aminotransferase, C-reactive protein, total serum calcium, serum lipase and amylase, arterial blood gases, abdominal ultrasonography and chest X-ray. Results: The study population consisted of 17 males and 23 females. The patients were being divided into two groups: group 1 that included 28 patients diagnosed as mild acute pancreatitis and group 2 that included 12 patients diagnosed as moderate to severe acute pancreatitis. Blood glucose, BUN, AST, CRP, serum lipase, BMI, hematocrit value, leukocytes and platelets count showed significant P value on comparing the two groups. Area under the curve (AUC) had been calculated for the above mentioned possible predictors and it represents the overall accuracy of all points. Blood glucose, AST and platelets count showed the highest AUC, sensitivity, specificity, PPV, NPV and accuracy among other proposed predictors, However, other proposed predictors showed high NPV. Conclusion: Blood glucose level, AST and platelets count showed the highest AUC, sensitivity, specificity, PPV, NPV and accuracy among other proposed predictors. Although other proposed predictors showed lower results than the above mentioned predictors, they still have a very significant NPV and can be used to rule out severe acute pancreatitis.