Original articlePancreas, biliary tract, and liverA Model to Predict the Severity of Acute Pancreatitis Based on Serum Level of Amylase and Body Mass Index
Section snippets
Methods
The diagnosis of AP was based on American College of Gastroenterology criteria and required the presence of at least 2 of the 3 following factors: (1) abdominal pain characteristic of AP, (2) serum amylase and/or lipase levels 3 or more times the upper limit of normal, and (3) CT findings characteristic of AP.1 Only patients with at least 2 serum amylase and lipase levels measured within the first 48 hours after admission were included in the study. Patients were classified as having SAP if
Results
Baseline characteristics of the discovery and the validation cohorts are presented in Table 1. The rule-out selection bias, the included and excluded patients from the discovery cohort, were compared and had similar age, etiology, Charlson comorbidity index, and BISAP score on day 1 of admission.
Discussion
This was a dual-center study that aimed to design a multivariable logistic regression model that accurately predicts SAP. We designed a novel multivariable model based on percentage changes in serum amylase levels during the first 2 days of admission and BMI, which accurately predicted the severity of AP. The initial findings using the discovery cohort subsequently were validated by an independent cohort of AP patients.
Serum amylase levels have long been used for the diagnosis of AP. In early
References (33)
- et al.
The epidemiology of pancreatitis and pancreatic cancer
Gastroenterology
(2013) - et al.
Statistical methods for quantifying the severity of clinical acute pancreatitis
J Surg Res
(1977) - et al.
APACHE-II score for assessment and monitoring of acute pancreatitis
Lancet
(1989) - et al.
Comparison of existing clinical scoring systems to predict persistent organ failure in patients with acute pancreatitis
Gastroenterology
(2012) - et al.
Obesity: a risk factor for severe acute biliary and alcoholic pancreatitis
Am J Gastroenterol
(1998) - et al.
Android fat distribution as predictor of severity in acute pancreatitis
Pancreatology
(2002) - et al.
Obesity is a definitive risk factor of severity and mortality in acute pancreatitis: an updated meta-analysis
Pancreatology
(2006) - et al.
Combination of APACHE-II score and an obesity score (APACHE-O) for the prediction of severe acute pancreatitis
Pancreatology
(2004) - et al.
Obesity increases the severity of acute pancreatitis: performance of APACHE-O score and correlation with the inflammatory response
Pancreatology
(2006) - et al.
Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis
Am J Gastroenterol
(2006)
Incidence and mortality of acute and chronic pancreatitis in the Netherlands: a nationwide record-linked cohort study for the years 1995-2005
World J Gastroenterol
Severe acute pancreatitis
JAMA
Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review
Pancreas
Clinical practice. Acute pancreatitis
N Engl J Med
Prognostic signs and the role of operative management in acute pancreatitis
Surg Gynecol Obstet
The early prediction of mortality in acute pancreatitis: a large population-based study
Gut
Cited by (0)
Conflicts of interest The authors disclose no conflicts.