ABSTRACT
Background: The objective of the study was to evaluate corrected calcium levels in patient of acute pancreatitis and to evaluate role of corrected calcium as predictor of severity in acute pancreatitis in comparison to computed tomography (CT) scan.Methods: The study was conducted in Department of Biochemistry of G.G.S Medical College in collaboration with the Department of Surgery and Department of Radio diagnosis. 50 patients, with clinical diagnosis of acute pancreatitis, attending the Inpatient Department of Department of Surgery, were taken. 50 patients, of either sex of 18 to 70 age groups suffering from acute pancreatitis were enrolled for the study.Results: On exploring the data, highly significant negative correlation found between CT severity index (CTSI) and serum calcium (p≤0.001; r value=-0.520) whereas the non-significant correlation found between CTSI and amylase (p=0.778; r value=-0.041). The corrected calcium and CTSI shows highly negative significant correlation (p≤0.001; r value=-0.654). Serum albumin with CTSI also shows significant correlation (p=0.006; r value=0.385). But no significant association with lipase (p≥0.05).Conclusions: We observed that corrected calcium and calcium is better and alternative marker for predicating the severity of disease because corrected calcium and calcium is having good positive predictive value to indicate progression of damage and also a highly significant negative predictive value to rule out severity of acute pancreatitis.
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Background: The objectives of this study are to describe the spectrum of Computed Tomography findings in cases of acute pancreatitis and to correlate the Computed Tomography Severity Indices with the clinical outcome of the patient. Methods: This descriptive study was done in Department of Radiodiagnosis, Government Medical College, Kannur on patients with suspected acute pancreatitis referred to Department of Radiodiagnosis for Contrast Enhanced Computed Tomography over a period of one year from 1/02/2016 to 31/01/2017. Results: 64 patients were studied, and 29 patients had mild, 22 had moderate and 13 had severe pancreatitis according to CTSI. According to MCTSI, 9, 35 and 20 patients had mild, moderate and severe pancreatitis respectively. The sensitivity of CTSI and MCTSI for predicting organ failure was 68.4 % and 94.7 % and specificity 100 % and 95.6 % respectively. The diagnostic accuracy of MCTSI was 95 % compared to 90 % for CTSI. MCTSI has a positive predictive value of 90 % and negative predictive value of 97.7 %. Conclusions: Both CTSI and MCTSI are extremely useful in predicting the patient outcome in acute pancreatitis in terms of hospital stay, need for intervention and development of organ failure. However, the sensitivity, negative predictive value and diagnostic accuracy are higher for MCTSI compared to CTSI.
ABSTRACT
BACKGROUND/AIMS: Early intestinal mucosal damage plays an important role in severe acute pancreatitis (AP). Previous studies have shown that intestinal permeability (IP), serum endotoxin and cytokines contribute to the early intestinal barrier dysfunction in AP. This study explored the predictive capacity of IP, endotoxemia and cytokines as prognostic indicators in AP patients. METHODS: Eighty-seven AP patients were included in the study. The patients were classified into three groups according to the Balthazar computed tomography severity index (CTSI). We compared the biochemical parameters, including IP, serum endotoxin level and cytokine level among the three groups. The associations of IP with serum endotoxin, cytokines, CTSI, and other widely used biochemical parameters and scoring systems were also examined. RESULTS: IP, serum endotoxin, interleukin (IL-6) and tumor necrosis factor (TNF)-alpha had a positive correlation with the CTSI of AP. Endotoxin, IL-6, TNF-alpha, CTSI, the Ranson/APACHE II score, the duration of hospital stay, complications and death significantly affect IP in the AP patients. CONCLUSIONS: We believe that IP with subsidiary measurements of serum endotoxin, IL-6 and TNF-alpha may be reliable markers for predicting the prognosis of AP. Further studies that can restore and preserve gut barrier function in AP patients are warranted.