Document Detail


Simplified admission criterion for predicting severe complications of gallstone pancreatitis.
MedLine Citation:
PMID:  10982509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HYPOTHESIS: Simple admission criteria (white blood cell count, > or =14. 5 x 10(9)/L; blood urea nitrogen level, > or =4.3 mmol/L [> or =12 mg/dL]; heart rate, > or =100 beats per minute; and serum glucose level, > or =8.3 mmol/L [> or =150 mg/dL]) are better predictors of severe complications of gallstone pancreatitis than an Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 5 or greater, a modified Imrie (Glasgow) score of 3 or greater, and a biliary Ranson score of 3 or greater. DESIGN: A prospective consecutive case study. SETTING: A university-affiliated, urban, public hospital. PATIENTS: Ninety-two consecutive patients (77 women and 15 men, aged 18 to 76 years [mean age, 39 years]) with gallstone pancreatitis. Seventy-seven patients were Hispanic. MAIN OUTCOME MEASURES: Major local and systemic complications requiring intensive care unit care, and death. RESULTS: Fourteen patients (15%) had severe complications with a mortality of 2%. On univariate analysis, a white blood cell count of 14.5 x 10(9)/L or more (P =.03), a serum glucose level of 8. 3 mmol/L or more (> or =150 mg/dL) (P<.001), an APACHE II score of 5 or greater (P =.008), a modified Imrie score of 3 or greater (P<.001), and a biliary Ranson score of 3 or greater (P =.03) were statistically associated with the development of severe complications; whereas a blood urea nitrogen level of 4.3 mmol/L or more (> or =12 mg/dL) and a heart rate of 100 beats per minute or more were not. On multivariate analysis, only a serum glucose level of 8. 3 mmol/L or more (> or =150 mg/dL) was predictive of adverse events (P<. 001). CONCLUSIONS: Glucose level (> or =8.3 mmol/L [> or =150 mg/dL]) is the best single admission predictor of severe complications of gallstone pancreatitis and is superior to an APACHE II score of 5 or greater, a modified Imrie score of 3 or greater, and a biliary Ranson score of 3 or greater.
Authors:
K Meek; K Toosie; B E Stabile; M Elbassir; Z Murrell; R J Lewis; L Chang; C de Virgilio
Related Documents :
23796769 - Dermatology life quality index and side effects after topical photodynamic therapy of a...
23317249 - Impact of adjuvant chemoradiotherapy for rectal cancer on the long-term quality of life...
23812159 - Localized acquired hypertrichosis after cast treatment in pediatric and adolescent pati...
24618329 - Health-related quality of life after cardiac surgery - the effects of age, preoperative...
24861049 - Six-year follow-up study on the effect of combined anterior and posterior spinal fusion...
8261929 - Mycobacterial cervical adenitis in children: medical and surgical management.
2205809 - Epo--one year later: a look at rehabilitation. the impact of long-term epoetin beta the...
16132989 - Evaluation of cervical spondylotic myelopathy using somatosensory-evoked potentials.
22410799 - Unilateral multicystic dysplastic kidney: does initial size matter?
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  135     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2000-09-28     Completed Date:  2000-09-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1048-52; discussion 1052-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Harbor-UCLA Medical Center, 1000 W Carson St, Box 25, Torrance, CA 90509, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Blood Glucose / analysis
Cholelithiasis / complications*
Female
Hospitalization*
Humans
Male
Middle Aged
Pancreatitis / etiology*
Predictive Value of Tests
Prognosis
Severity of Illness Index*
Chemical
Reg. No./Substance:
0/Blood Glucose
Comments/Corrections
Comment In:
Arch Surg. 2001 Oct;136(10):1210   [PMID:  11585517 ]

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


Previous Document:  Anticoagulation of children undergoing cardiopulmonary bypass is overestimated by current monitoring...
Next Document:  Effect of an esophageal bougie on the incidence of dysphagia following nissen fundoplication: a pros...