High Serum Creatinine in Acute Pancreatitis: A Marker for Pancreatic Necrosis?
| Autor: | Patrick Maisonneuve, Albert B. Lowenfels, Paul Georg Lankisch, Bettina Weber-Dany |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology Time Factors Necrosis Critical Illness Contrast Media Sensitivity and Specificity Gastroenterology chemistry.chemical_compound Risk Factors Internal medicine medicine Humans Prospective Studies Prospective cohort study Aged Creatinine Hepatology Pancreatitis Acute Necrotizing business.industry High serum Middle Aged medicine.disease Elevated creatinine Radiographic Image Enhancement chemistry Pancreatitis Acute pancreatitis Female medicine.symptom Tomography X-Ray Computed Complication business Biomarkers Follow-Up Studies |
| Zdroj: | American Journal of Gastroenterology. 105:1196-1200 |
| ISSN: | 0002-9270 |
| Popis: | High serum creatinine is a well-known unfavorable prognostic parameter in acute pancreatitis. Elevated creatinine at 48 h after admission was recently described as a marker for pancreatic necrosis. As pancreatic necrosis is a serious complication of acute pancreatitis and its identification by a simple single laboratory test would be very helpful, the aim of this study was to test that statement.In a prospective multicenter study of 462 patients with a first attack of acute pancreatitis, serum creatinine was determined on admission, and at 24 and 48 h thereafter, and compared with the findings of contrast-enhanced computed tomography (CT) performed within 96 h of admission.Pancreatic necrosis was present in 62 (13%) of the patients. Serum creatinine levels (abnormalor = 2 mg/dl) on admission and after 24 and 48 h were evaluated vs. the presence or absence of pancreatic necrosis. Sensitivity rates varied between 14 and 23%, specificity between 95 and 97%, positive predictive values between 41 and 50%, and negative predictive values between 87 and 89%. Receiver operating characteristic curves revealed an area under the curve of between 0.604 and 0.669.An elevated serum creatinine concentration at any time during the first 48 h of admission is not a marker for pancreatic necrosis in a first attack of acute pancreatitis. If serum creatinine is normal, necrotizing pancreatitis is unlikely, and contrast-enhanced CT need not be performed unless complications occur and/or the patient's condition deteriorates. |
| Databáze: | OpenAIRE |
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