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Diagnosing acute pancreatitis-Clinical and radiological characterisation of patients without threefold increase of serum lipase

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Diagnosing acute pancreatitis-Clinical and radiological characterisation of patients without threefold increase of serum lipase. / Avanesov, Maxim; Löser, Anastassia; Keller, Sarah; Weinrich, Julius M; Laqmani, Azien; Adam, Gerhard; Karul, Murat; Yamamura, Jin.

In: EUR J RADIOL, Vol. 95, 10.2017, p. 278-285.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Avanesov, M, Löser, A, Keller, S, Weinrich, JM, Laqmani, A, Adam, G, Karul, M & Yamamura, J 2017, 'Diagnosing acute pancreatitis-Clinical and radiological characterisation of patients without threefold increase of serum lipase', EUR J RADIOL, vol. 95, pp. 278-285. https://doi.org/10.1016/j.ejrad.2017.08.038

APA

Avanesov, M., Löser, A., Keller, S., Weinrich, J. M., Laqmani, A., Adam, G., Karul, M., & Yamamura, J. (2017). Diagnosing acute pancreatitis-Clinical and radiological characterisation of patients without threefold increase of serum lipase. EUR J RADIOL, 95, 278-285. https://doi.org/10.1016/j.ejrad.2017.08.038

Vancouver

Avanesov M, Löser A, Keller S, Weinrich JM, Laqmani A, Adam G et al. Diagnosing acute pancreatitis-Clinical and radiological characterisation of patients without threefold increase of serum lipase. EUR J RADIOL. 2017 Oct;95:278-285. https://doi.org/10.1016/j.ejrad.2017.08.038

Bibtex

@article{a432948eeeb04d90a3649bf7cdf4b1c5,
title = "Diagnosing acute pancreatitis-Clinical and radiological characterisation of patients without threefold increase of serum lipase",
abstract = "OBJECTIVES: Diagnosing acute pancreatitis (AP) may be challenging in patients with acute abdominal pain but missing threefold increased serum lipase levels (Lip-). This studyaims both to characterize these patients using clinical, radiological and mortality data, and to assess the group of patients who need contrast-enhanced computed tomography (CECT).METHODS: In this retrospective, IRB approved study 234 consecutive patients with AP were investigated. Inclusion criteria were single (SAP) and recurrent attacks (RAP) of AP and CECT ≥72h after onset of symptoms. Severity of AP was assessed by C-reactive protein at 48h after hospital admission and using 3 CT-based scores (CTSI, mCTSI, EPIC) by 2 observers. Mortality rates from pancreatic and non-pancreatic causes were noted with regard to lipase increase. Results were compared with paired t-test and Wilcoxon signed-rank test.RESULTS: 64/234 (27%) patients belonged to Lip- group and 170/234 (73%) patients were allocated to Lip+ group. Significantly more male patients (78% in Lip- vs. 63% in Lip+, p<0.05) with RAP (63% in Lip- vs. 21% in Lip+, p<0.001) were observed in the Lip- group. EPIC was significantly lower in Lip- group compared to Lip+ group (3(IQR 2-5) vs. 2(IQR 1-3), p<0.001). Mortality from pancreatic and non-pancreatic causes was comparable in Lip- and Lip+ group (pancreatic causes: 9% vs. 6%, p=0.60; nonpancreatic causes: 8% vs. 5%, p=0.58).CONCLUSIONS: 27% of all patients with AP presented without threefold increase of lipase levels. Thus, they would be underdiagnosed without confirming CECT, which revealed significantly lower counts of pleural effusions and ascites. Male patients with RAP were found significantly more often among the Lip- group. Hence, they would benefit the most from CECT for diagnosing AP.",
keywords = "Journal Article",
author = "Maxim Avanesov and Anastassia L{\"o}ser and Sarah Keller and Weinrich, {Julius M} and Azien Laqmani and Gerhard Adam and Murat Karul and Jin Yamamura",
note = "Copyright {\textcopyright} 2017. Published by Elsevier B.V.",
year = "2017",
month = oct,
doi = "10.1016/j.ejrad.2017.08.038",
language = "English",
volume = "95",
pages = "278--285",
journal = "EUR J RADIOL",
issn = "0720-048X",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Diagnosing acute pancreatitis-Clinical and radiological characterisation of patients without threefold increase of serum lipase

AU - Avanesov, Maxim

AU - Löser, Anastassia

AU - Keller, Sarah

AU - Weinrich, Julius M

AU - Laqmani, Azien

AU - Adam, Gerhard

AU - Karul, Murat

AU - Yamamura, Jin

N1 - Copyright © 2017. Published by Elsevier B.V.

PY - 2017/10

Y1 - 2017/10

N2 - OBJECTIVES: Diagnosing acute pancreatitis (AP) may be challenging in patients with acute abdominal pain but missing threefold increased serum lipase levels (Lip-). This studyaims both to characterize these patients using clinical, radiological and mortality data, and to assess the group of patients who need contrast-enhanced computed tomography (CECT).METHODS: In this retrospective, IRB approved study 234 consecutive patients with AP were investigated. Inclusion criteria were single (SAP) and recurrent attacks (RAP) of AP and CECT ≥72h after onset of symptoms. Severity of AP was assessed by C-reactive protein at 48h after hospital admission and using 3 CT-based scores (CTSI, mCTSI, EPIC) by 2 observers. Mortality rates from pancreatic and non-pancreatic causes were noted with regard to lipase increase. Results were compared with paired t-test and Wilcoxon signed-rank test.RESULTS: 64/234 (27%) patients belonged to Lip- group and 170/234 (73%) patients were allocated to Lip+ group. Significantly more male patients (78% in Lip- vs. 63% in Lip+, p<0.05) with RAP (63% in Lip- vs. 21% in Lip+, p<0.001) were observed in the Lip- group. EPIC was significantly lower in Lip- group compared to Lip+ group (3(IQR 2-5) vs. 2(IQR 1-3), p<0.001). Mortality from pancreatic and non-pancreatic causes was comparable in Lip- and Lip+ group (pancreatic causes: 9% vs. 6%, p=0.60; nonpancreatic causes: 8% vs. 5%, p=0.58).CONCLUSIONS: 27% of all patients with AP presented without threefold increase of lipase levels. Thus, they would be underdiagnosed without confirming CECT, which revealed significantly lower counts of pleural effusions and ascites. Male patients with RAP were found significantly more often among the Lip- group. Hence, they would benefit the most from CECT for diagnosing AP.

AB - OBJECTIVES: Diagnosing acute pancreatitis (AP) may be challenging in patients with acute abdominal pain but missing threefold increased serum lipase levels (Lip-). This studyaims both to characterize these patients using clinical, radiological and mortality data, and to assess the group of patients who need contrast-enhanced computed tomography (CECT).METHODS: In this retrospective, IRB approved study 234 consecutive patients with AP were investigated. Inclusion criteria were single (SAP) and recurrent attacks (RAP) of AP and CECT ≥72h after onset of symptoms. Severity of AP was assessed by C-reactive protein at 48h after hospital admission and using 3 CT-based scores (CTSI, mCTSI, EPIC) by 2 observers. Mortality rates from pancreatic and non-pancreatic causes were noted with regard to lipase increase. Results were compared with paired t-test and Wilcoxon signed-rank test.RESULTS: 64/234 (27%) patients belonged to Lip- group and 170/234 (73%) patients were allocated to Lip+ group. Significantly more male patients (78% in Lip- vs. 63% in Lip+, p<0.05) with RAP (63% in Lip- vs. 21% in Lip+, p<0.001) were observed in the Lip- group. EPIC was significantly lower in Lip- group compared to Lip+ group (3(IQR 2-5) vs. 2(IQR 1-3), p<0.001). Mortality from pancreatic and non-pancreatic causes was comparable in Lip- and Lip+ group (pancreatic causes: 9% vs. 6%, p=0.60; nonpancreatic causes: 8% vs. 5%, p=0.58).CONCLUSIONS: 27% of all patients with AP presented without threefold increase of lipase levels. Thus, they would be underdiagnosed without confirming CECT, which revealed significantly lower counts of pleural effusions and ascites. Male patients with RAP were found significantly more often among the Lip- group. Hence, they would benefit the most from CECT for diagnosing AP.

KW - Journal Article

U2 - 10.1016/j.ejrad.2017.08.038

DO - 10.1016/j.ejrad.2017.08.038

M3 - SCORING: Journal article

C2 - 28987680

VL - 95

SP - 278

EP - 285

JO - EUR J RADIOL

JF - EUR J RADIOL

SN - 0720-048X

ER -