Analysis of the power of common diagnostic tools in the management of acute pancreatitis
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Analysis of the power of common diagnostic tools in the management of acute pancreatitis. / Nistal, Markus; Zoltani, Malai; Lohse, Ansgar W; Di Daniele, Nicola; Tesauro, Manfredi; Pace, Andrea.
In: GASTROENT RES PRACT, Vol. 2014, 01.01.2014, p. 438697.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Analysis of the power of common diagnostic tools in the management of acute pancreatitis
AU - Nistal, Markus
AU - Zoltani, Malai
AU - Lohse, Ansgar W
AU - Di Daniele, Nicola
AU - Tesauro, Manfredi
AU - Pace, Andrea
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Acute pancreatitis (AP) is a serious medical condition usually associated with severe upper abdominal pain. The purpose of our study is to assess the therapeutic consequences of contrast-enhanced computed tomography (CE-CT) and the predictive value of CRP for severe pancreatitis. We included patients with a threefold increase of plasma lipase who had received a CE-CT or had a CRP of =150 mg/dl. A total of 74 out of 283 patients got a contrast-enhanced CT scan; in 11 cases the CT was followed by endoscopic or surgical interventions as therapeutic consequences compared with 19 out of 50 control cases. 69 out of 283 patients (24,3%) had CRP >150 mg/dl within 48 hours after admission. 32 of them had SAP. The CRP cutoff of 150 mg/L had a sensitivity of 80% and a specificity of 65%. The positive predictive value for SAP in patients beyond the cutoff is 46.4%. The negative predictive value for SAP in patients below the cutoff was 89.5%. Our results support the opinion that an early CE-CT is usually not indicated. CRP helps to assess the course of AP; levels below 150 mg/dl between the first 48 h indicate a mild course in most of the cases.
AB - Acute pancreatitis (AP) is a serious medical condition usually associated with severe upper abdominal pain. The purpose of our study is to assess the therapeutic consequences of contrast-enhanced computed tomography (CE-CT) and the predictive value of CRP for severe pancreatitis. We included patients with a threefold increase of plasma lipase who had received a CE-CT or had a CRP of =150 mg/dl. A total of 74 out of 283 patients got a contrast-enhanced CT scan; in 11 cases the CT was followed by endoscopic or surgical interventions as therapeutic consequences compared with 19 out of 50 control cases. 69 out of 283 patients (24,3%) had CRP >150 mg/dl within 48 hours after admission. 32 of them had SAP. The CRP cutoff of 150 mg/L had a sensitivity of 80% and a specificity of 65%. The positive predictive value for SAP in patients beyond the cutoff is 46.4%. The negative predictive value for SAP in patients below the cutoff was 89.5%. Our results support the opinion that an early CE-CT is usually not indicated. CRP helps to assess the course of AP; levels below 150 mg/dl between the first 48 h indicate a mild course in most of the cases.
U2 - 10.1155/2014/438697
DO - 10.1155/2014/438697
M3 - SCORING: Journal article
C2 - 25214831
VL - 2014
SP - 438697
JO - GASTROENT RES PRACT
JF - GASTROENT RES PRACT
SN - 1687-6121
ER -