Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Original Article

Volume 3, Number 1, February 2010, pages 25-31

Simplified Early Predictors of Severe Acute Pancreatitis: A Prospective Study

**Table 1.** Demographic Data of Patients With Severe and Mild Acute Pancreatitis
	Severe Pancreatitis (n= 27)	Mild Pancreatitis (n=122)	P Value
EOF: End Organ Failure
Age (years)	47 ± 2.1	43 ± 2	0.21
Sex (male/female)	15/12	67/55	0.76
Etiology of AP
Gall stones	15	62	0.58
Non gall stones	12	60	0.96
Time of hospitalization (days)	25 (12-38)	7 (5-9)	0.03
BMI (kg/m²)	30.9 ( 27.9 - 34.2)	25.4 (23.4 - 28.1)	0.007
Patients with EOF
Respiratory	11	0
Renal	3	0
Shock	1	0
Total	15	0	0.002

Table 1. Demographic Data of Patients With Severe and Mild Acute Pancreatitis

Severe Pancreatitis (n= 27)

Mild Pancreatitis (n=122)

P Value

EOF: End Organ Failure

Age (years)

47 ± 2.1

43 ± 2

0.21

Sex (male/female)

15/12

67/55

0.76

Etiology of AP

Gall stones

0.58

Non gall stones

0.96

Time of hospitalization (days)

25 (12-38)

7 (5-9)

0.03

BMI (kg/m²)

30.9 ( 27.9 - 34.2)

25.4 (23.4 - 28.1)

0.007

Patients with EOF

Respiratory

Renal

Shock

Total

0.002

**Table 2.** Significant Prognostic Factors Between Severe and Mild Pancreatitis Groups by Univariate Analysis
	Group I (n = 27)	Group II (n = 122)	P Value
BMI: Body Mass Index; BUN: Blood Urea Nitrogen; CRP: C reactive protein; WBC: White Blood Cell; AST: Aspartate aminotransferase
Age (years)	53 ± 9	49 ± 2	0.21
BMI
25 - 30 kg/m²	11	12	0.03
≥ 30 kg/m²	14	6	0.02
Creatinine (mg/dL)	1.9 ± 0.6	1.1 ± 0.3	0.11
BUN (mg/dL)	33 ± 4	27 ± 2	0.55
CRP (mg/dL)	20 ± 2	18 ± 1	0.07
WBCs (cells / mm³)	9 ± 7.5	7 ± 3.1	0.82
Hematocrit (%)	46.1 ± 5.9	41.8 ± 4.2	0.001
Blood sugar (mg/dL)	273 ± 31	149 ± 3	0.01
Calcium (mg/dL)	6.0 ± 0.3	7.4 ± 0.1	0.67
Total bilirubin level (mg/dL)	2.1 ± 0.4	1.7 ± 0.2	0.09
AST (IU/L)	128 ± 65	112 ± 16	0.07
Amylase (U/L)	731 ± 176	638 ± 81	0.11
Lipase (U/L)	903 ± 96	711 ± 47	0.34
Chest X-ray (no.)	22	10	< 0.001

Table 2. Significant Prognostic Factors Between Severe and Mild Pancreatitis Groups by Univariate Analysis

Group I (n = 27)

Group II (n = 122)

P Value

BMI: Body Mass Index; BUN: Blood Urea Nitrogen; CRP: C reactive protein; WBC: White Blood Cell; AST: Aspartate aminotransferase

Age (years)

53 ± 9

49 ± 2

0.21

BMI

25 - 30 kg/m²

0.03

≥ 30 kg/m²

0.02

Creatinine (mg/dL)

1.9 ± 0.6

1.1 ± 0.3

0.11

BUN (mg/dL)

33 ± 4

27 ± 2

0.55

CRP (mg/dL)

20 ± 2

18 ± 1

0.07

WBCs (cells / mm³)

9 ± 7.5

7 ± 3.1

0.82

Hematocrit (%)

46.1 ± 5.9

41.8 ± 4.2

0.001

Blood sugar (mg/dL)

273 ± 31

149 ± 3

0.01

Calcium (mg/dL)

6.0 ± 0.3

7.4 ± 0.1

0.67

Total bilirubin level (mg/dL)

2.1 ± 0.4

1.7 ± 0.2

0.09

AST (IU/L)

128 ± 65

112 ± 16

0.07

Amylase (U/L)

731 ± 176

638 ± 81

0.11

Lipase (U/L)

903 ± 96

711 ± 47

0.34

Chest X-ray (no.)

< 0.001

**Table 3.** Time Intervals and Hematocrit Values in Severe Versus Mild Pancreatitis
	Group I (n = 27)	Group II (n = 122)	P Value
Interval of time between onset of pain and admission (h)	18 (6, 72)	20 (7, 84)	0.98
Interval of time between first and second hematocrit measurements (h)	24 (20, 28)	24 (18, 25)	0.34
Hematocrit at admission (%)	46.1 (38.4 - 51.4)	41.8 (31- 47.1)	< 0.001
Hematocrit after 24 hours (%)	43.9 (31.4 - 53.9)	37.8 (26 - 46.6)	< 0.001

Table 3. Time Intervals and Hematocrit Values in Severe Versus Mild Pancreatitis

Group I (n = 27)

Group II (n = 122)

P Value

Interval of time between onset of pain and admission (h)

18 (6, 72)

20 (7, 84)

0.98

Interval of time between first and second hematocrit measurements (h)

24 (20, 28)

24 (18, 25)

0.34

Hematocrit at admission (%)

46.1 (38.4 - 51.4)

41.8 (31- 47.1)

< 0.001

Hematocrit after 24 hours (%)

43.9 (31.4 - 53.9)

37.8 (26 - 46.6)

< 0.001

**Table 4.** Hematocrit as a Marker for Severe Acute Pancreatitis
Severe Acute Pancreatitis	Sensitivity	Specificity	PPV	NPV
PPV: positive predictive value; NPV: negative predictive value
Hematocrit criteria
At admission	76%	81%	70%	81%
(43%, 89%)	(64%, 93%)	(44%, 87%)	(73%, 92%)
At 24 hours	95%	71%	63%	92%
(78%, 100%)	(55%, 84%)	(43%, 80%)	(77%, 96%)

Table 4. Hematocrit as a Marker for Severe Acute Pancreatitis

Severe Acute Pancreatitis

Sensitivity

Specificity

PPV

NPV

PPV: positive predictive value; NPV: negative predictive value

Hematocrit criteria

At admission

76%

81%

70%

81%

(43%, 89%)

(64%, 93%)

(44%, 87%)

(73%, 92%)

At 24 hours

95%

71%

63%

92%

(78%, 100%)

(55%, 84%)

(43%, 80%)

(77%, 96%)

**Table 5.** Distribution of Pleural Effusion in Severe Versus Mild Acute Pancreatitis
	SAP with effusion (N = 22)	Mild AP with effusion (N = 10)	Total (N = 32)
Left-sided	5	3	8 (25%)
Right sided	1	1	2 (6.3%)
Bilateral	16	6	22 (68.8%)

Table 5. Distribution of Pleural Effusion in Severe Versus Mild Acute Pancreatitis

SAP with effusion (N = 22)

Mild AP with effusion (N = 10)

Total (N = 32)

Left-sided

8 (25%)

Right sided

2 (6.3%)

Bilateral

22 (68.8%)