Document Detail


Elevated amylase and lipase levels in the neurosurgery intensive care unit.
MedLine Citation:
PMID:  20103485     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Multiple factors may affect pancreatic enzyme levels even in the absence of pancreatitis. In the general intensive care unit (ICU), we examined the incidence, various clinical factors, and sequelae associated with elevated pancreatic enzymes in the neurosurgery ICU. METHODS: Eighty-nine patients who were admitted to the neurosurgery ICU with gastrointestinal symptoms and signs from January to October 2007 were classified into 2 groups according to their pancreatic enzymes as follows: normal pancreatic enzyme levels (n = 46) and elevated levels (n = 43). We analyzed the general data, including sex, age, indications for admission, types of surgery, initial Glasgow coma scale (GCS) score, neurosurgery ICU-stay days, and mechanical ventilator- use days. We also collected data on vital signs, serum markers, and drug prescriptions. Radiological examinations, including sonography and computed tomography (CT) scans of the abdomen were performed. RESULTS: Nearly half of the patients who were admitted to the neurosurgical ICU with gastrointestinal symptoms and signs had elevated serum pancreatic enzymes. Elevated pancreatic enzyme levels were significantly associated with anemia (p = 0.048) and renal failure (p = 0.026), and were not associated with sex, age, indications for admission, types of surgery, initial GCS, neurosurgery ICU-stay days, mechanical ventilator-use days, hypotension, fever, usual ICU drugs, and other serum hepatic markers. High pancreatic enzyme levels were associated with a high mortality (p = 0.02). Abdominal CT had a high positive-predictive rate for the diagnosis of pancreatitis (63%). CONCLUSION: Various neurosurgery events and diagnoses may lead to different degrees of serum pancreatic enzyme elevation. Patients with elevated pancreatic enzyme levels have a higher mortality rate than those with normal enzyme levels. We believe that abdominal CT should be indicated for patients if their amylase levels are more than 3-fold the upper normal limit and lipase levels are more than 5-fold.
Authors:
Cheng-Chia Lee; Wen-Yuh Chung; Yang-Hsin Shih
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Chinese Medical Association : JCMA     Volume:  73     ISSN:  1728-7731     ISO Abbreviation:  J Chin Med Assoc     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-05-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101174817     Medline TA:  J Chin Med Assoc     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  8-14     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C. cclee12@vghtpe.gov.tw
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MeSH Terms
Descriptor/Qualifier:
APACHE
Adult
Age Factors
Aged
Amylases / blood*
Female
Humans
Intensive Care Units*
Lipase / blood*
Male
Middle Aged
Neurosurgical Procedures*
Pancreatitis / diagnosis
Retrospective Studies
Chemical
Reg. No./Substance:
EC 3.1.1.3/Lipase; EC 3.2.1.-/Amylases
Comments/Corrections
Comment In:
J Chin Med Assoc. 2010 Mar;73(3):129-30   [PMID:  20230996 ]

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