Has Blood Glucose Level Measured on Admission to Hospital in a Patient with Acute Pancreatitis Any Prognostic Value?

Paul Georg Lankisch, Torsten Blum, Anja Bruns, Michael Dröge, Gisbert Brinkmann, Karl Struckmann, Michael Nauck, Patrick Maisonneuve, Albert B. Lowenfels

Research output: Contribution to journalArticle

Abstract

Background: Early detection of pancreatic necrosis allows better management of the disease. Contrast-enhanced computed tomography (CT) as the gold standard for detecting pancreatic necrosis is expensive. Aim of the Study: This study was to evaluate for the first time whether blood glucose estimation on hospital admission - a simple, cheap, readily available laboratory parameter - may detect pancreatic necrosis and have prognostic value in acute pancreatitis. Methods: Single blood glucose estimation upon hospital admission was evaluated prospectively for detecting pancreatic necrosis and as a prognostic indicator. The study included 241 nondiabetic patients with a first attack of acute pancreatitis. All underwent CT within 72 h of admission. Results: High blood glucose (>125 mg/dl) correlated significantly with complex high clinical and biochemical prognostic scores (Ranson, Imrie), a high Balthazar score, pancreatic pseudocysts, and a long hospital stay, but not with organ failure, indication for artificial ventilation, dialysis, surgery, length of intensive care, and mortality. Pancreatic necrosis detection sensitivity of high blood glucose was 83%, specificity 49%, positive predictive value 28%, and negative predictive value 92%. Conclusion: A patient with normal blood glucose on admission is unlikely to have pancreatic necrosis. Contrast-enhanced CT would not be needed unless the patient fails to improve.

Original languageEnglish
Pages (from-to)224-229
Number of pages6
JournalPancreatology
Volume1
Issue number3
DOIs
Publication statusPublished - 2001

Keywords

  • Acute pancreatitis
  • Blood glucose
  • Computed tomography
  • Pancreatic necrosis
  • Prognosis
  • Prognostic parameters

ASJC Scopus subject areas

  • Endocrinology
  • Gastroenterology

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    Lankisch, P. G., Blum, T., Bruns, A., Dröge, M., Brinkmann, G., Struckmann, K., Nauck, M., Maisonneuve, P., & Lowenfels, A. B. (2001). Has Blood Glucose Level Measured on Admission to Hospital in a Patient with Acute Pancreatitis Any Prognostic Value? Pancreatology, 1(3), 224-229. https://doi.org/10.1159/000055815