TY - JOUR
T1 - Has Blood Glucose Level Measured on Admission to Hospital in a Patient with Acute Pancreatitis Any Prognostic Value?
AU - Lankisch, Paul Georg
AU - Blum, Torsten
AU - Bruns, Anja
AU - Dröge, Michael
AU - Brinkmann, Gisbert
AU - Struckmann, Karl
AU - Nauck, Michael
AU - Maisonneuve, Patrick
AU - Lowenfels, Albert B.
PY - 2001
Y1 - 2001
N2 - 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.
AB - 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.
KW - Acute pancreatitis
KW - Blood glucose
KW - Computed tomography
KW - Pancreatic necrosis
KW - Prognosis
KW - Prognostic parameters
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U2 - 10.1159/000055815
DO - 10.1159/000055815
M3 - Article
C2 - 12120199
AN - SCOPUS:0035552220
VL - 1
SP - 224
EP - 229
JO - Pancreatology
JF - Pancreatology
SN - 1424-3903
IS - 3
ER -