Document Detail


Has blood glucose level measured on admission to hospital in a patient with acute pancreatitis any prognostic value?
MedLine Citation:
PMID:  12120199     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
P G Lankisch; T Blum; A Bruns; M Dröge; G Brinkmann; K Struckmann; M Nauck; P Maisonneuve; A B Lowenfels
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]     Volume:  1     ISSN:  1424-3903     ISO Abbreviation:  Pancreatology     Publication Date:  2001  
Date Detail:
Created Date:  2002-07-17     Completed Date:  2002-08-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100966936     Medline TA:  Pancreatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  224-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Municipal Clinic of Lüneburg.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Blood Glucose / metabolism*
Diagnostic Tests, Routine*
Female
Humans
Male
Middle Aged
Pancreatitis / blood,  diagnosis*
Predictive Value of Tests
Prognosis
Prospective Studies
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Blood Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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