Calcio sérico total y calcio corregido como predictores de severidad en pancreatitis aguda

Gutiérrez-Jiménez, A.A.; Castro-Jiménez, E.; Lagunes-Córdoba, Roberto

doi:10.1016/j.rgmx.2013.08.003

Cited by 12 publications

(7 citation statements)

References 34 publications

(33 reference statements)

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“…Similarly, when ACC of 7.72 mg/dl was computed as cutoff for severe AP, we found sensitivity of 88%, specificity of 69.1%, PPV of 56.4%, and NPV of 92.7%. When 7.5 mg/dl is taken as a cutoff value for albumin-corrected calcium in our study, the sensitivity and negative predictive values decreased up to 80% and 89.1%, respectively, and while comparing the sensitivity, specificity, and predictive values of ACC with that of the study done by Gutierrez-Jimenez et al [ 5 ], our sensitivity was much higher (88% versus 67%) and a positive predictive value (56.4% versus 40%) was obtained when the cutoff value was taken as 7.72 mg/dl. As explained above, the higher sensitivity and PPV could be due to the higher cutoff value in our study.…”

Section: Discussionsupporting

confidence: 51%

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Prediction of Severity of Acute Pancreatitis Using Total Serum Calcium and Albumin-Corrected Calcium: A Prospective Study in Tertiary Center Hospital in Nepal

Pokharel

Sigdel

Phuyal

et al. 2017

Surgery Research and Practice

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Introduction Total calcium (TC) and albumin-corrected calcium (ACC) are easily accessible AP severity tests in the Primary Health Care Center of Nepal. The aim of the study was to evaluate TC and ACC as prognostic severity markers in acute pancreatitis (AP). Methods All patients admitted in Tribhuvan University Teaching Hospital with the diagnosis of AP were studied prospectively over a period of one year from January 2015 to January 2016. TC and ACC were measured in the first 24 hours of admission in each patient. The modified Marshall score was determined at admission and at 48 hours and at any point of time during admission as per the need of the patient. Severity of acute pancreatitis was defined as per the Revised Atlanta Classification 2012. Results 80 patients of AP were included in the study. Among them, 14% were categorized as having severe AP. The mean total calcium was 8.22, 7.51, and 6.98 for mild, moderate, and severe AP, respectively, which was significant at 0.001. Conclusion TC and ACC, measured within the first 24 hours, are useful severity predictors in acute pancreatitis.

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Section: Discussionsupporting

confidence: 51%

“…It has been evaluated as a mortality prognostic factor and has also been evaluated as a predictor of severe AP with infection. Albumin-corrected calcium has also been associated with severity [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Prediction of Severity of Acute Pancreatitis Using Total Serum Calcium and Albumin-Corrected Calcium: A Prospective Study in Tertiary Center Hospital in Nepal

Pokharel

Sigdel

Phuyal

et al. 2017

Surgery Research and Practice

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“…Total calcium and corrected calcium have shown similar efficacy like that of Ranson and APACHE II score in prediction of SAP. In a prospective study of 96 patients, Gutiérrez-Jiménez et al have found sensitivity, specificity, positive predictive value, and negative predictive value of 67%, 82%, 27%, and 96% at a maximum cut-off level of 7.5 mg/dL for total calcium and 67%, 90%, 40%, and 96% for corrected calcium with a maximum cut-off level of 7.5 mg/dL [ 104 ].…”

Section: Emerging Potential Biomarkers For Prediction Of Severity mentioning

confidence: 99%

Role of Biomarkers in Diagnosis and Prognostic Evaluation of Acute Pancreatitis

Meher

Mishra

Sasmal

et al. 2015

Journal of Biomarkers

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Acute pancreatitis is a potentially life threatening disease. The spectrum of severity of the illness ranges from mild self-limiting disease to a highly fatal severe necrotizing pancreatitis. Despite intensive research and improved patient care, overall mortality still remains high, reaching up to 30–40% in cases with infected pancreatic necrosis. Although little is known about the exact pathogenesis, it has been widely accepted that premature activation of digestive enzymes within the pancreatic acinar cell is the trigger that leads to autodigestion of pancreatic tissue which is followed by infiltration and activation of leukocytes. Extensive research has been done over the past few decades regarding their role in diagnosis and prognostic evaluation of severe acute pancreatitis. Although many standalone biochemical markers have been studied for early assessment of severity, C-reactive protein still remains the most frequently used along with Interleukin-6. In this review we have discussed briefly the pathogenesis and the role of different biochemical markers in the diagnosis and severity evaluation in acute pancreatitis.

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“…MM score was also recently used to determine AP severity [ 3 ]. Other single serum markers of AP severity have been extensively studied, such as hematocrit, creatinine, BUN, TSC, lactate and CRP [ 4 , 7 , 21 – 23 ]. In addition, some serum pro- and anti-inflammatory markers have been proved to be associated with AP severity, such as interleukin-6, interlekin-8, interleukin-10 and tumor necrosis factor alpha; and serum procalcitonin, a reliable marker of infection/sepsis and useful for predicting infected necrosis in AP.…”

Section: Discussionmentioning

confidence: 99%

Red cell distribution width and red cell distribution width to total serum calcium ratio as major predictors of severity and mortality in acute pancreatitis

Gravito-Soares

Gomes

et al. 2018

BMC Gastroenterol

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BackgroundAcute pancreatitis (AP) is associated with considerable morbidity and mortality. Current severity scores include multiple variables and some of them are only complete within 48 h of admission. Red cell distribution width (RDW) is a simple and routine parameter that seems to be related to inflammatory status. Our aims were to evaluate the diagnostic value of RDW in severity and mortality of AP comparing with other prognostic scoring systems.MethodsRetrospective case-control study of a total of 312 patients with AP admitted between 2014 and 2016. Patients with severe AP (cases) were compared with patients with mild AP (controls) in the 1:1 proportion. Additionally, a comparison between survivor and nonsurvivor AP patients was performed. Diagnosis and severity of AP were defined according to the revised Atlanta classification 2012. Variables evaluated included demographics, comorbidities, hospital stay, laboratorial parameters, arterial blood gas analysis, prognostic scores within 24 h of admission (Ranson, BISAP and Modified Marshall) and mortality.ResultsIncluded 91 cases of severe AP, most males (58.2% vs 51.6%; p = 0.228) with mean age of 64.8 ± 16.3 years (vs 67.9 ± 13.7; p = 0.239). RDW0h was higher in patients with severe AP (14.6 ± 1.3 vs 12.7 ± 0.5; p < 0.001), as well as RDW0h-to-serum calcium ratio (1.8 ± 0.3 vs 1.3 ± 0.1; p < 0.001). After multivariate and ROC curve analysis, RDW0h (AUROC: 0.960; p < 0.001) and RDW0h-to-serum calcium ratio (AUROC: 0.973; p < 0.001) were the major predictors of severe AP for a cut-off value of 13.0 (S: 92.7%; Sp: 84.3%) and 1.4 (S: 96.3%; Sp: 84.3%), respectively. These factors were superior to prognostic scores, such as Ranson (AUROC: 0.777; p < 0.001; cut-off: 3.0), BISAP (AUROC: 0.732; p < 0.001; cut-off: 2.0) and Modified Marshall (AUROC: 0.756; p < 0.001; cut-off: 1.0). The mortality rate was 8.8% (16/182), all cases associated with severe AP (17.6%; 16/91). RDW0h and RDW0h-to-serum calcium ratio were higher in nonsurvivor AP patients (15.3 ± 1.4 vs 13.5 ± 1.3; p < 0.001 and 2.0 ± 0.3 vs 1.6 ± 0.3; p < 0.001, respectively). In multivariate and ROC curve analysis, RDW0h (AUROC: 0.842; p < 0.001; cut-off: 14.0), RDW24h (AUROC: 0.848; p < 0.001; cut-off: 13.8) and RDW0h-to-serum calcium ratio (AUROC: 0.820; p < 0.001; cut-off: 1.7) were independent predictors for AP mortality, superior to conventional prognostic scoring systems Ranson (AUROC: 0.640; p = 0.003; cut-off:3.0), BISAP (AUROC: 0.693; p = 0.017; cut-off: 2.0) and Modified Marshall (AUROC: 0.806; p < 0.001; cut-off:1.0).ConclusionsRDW is a simple routine parameter, available at admission. This AP cohort showed that RDW0h > 13.0 and RDW0h-to-total serum calcium ratio > 1.4 were excellent predictors for severity and RDW0h > 14.0 and RDW0h-to-total serum calcium ratio > 1.7 were very-good predictors for mortality, being superior to conventional prognostic scoring systems.

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Calcio sérico total y calcio corregido como predictores de severidad en pancreatitis aguda

Abstract: TC and ACC, measured within the first 24hours, are useful severity predictors in acute pancreatitis, with sensitivity and predictive values comparable or superior to those of the conventional prognostic scales.

Cited by 12 publications

References 34 publications

Prediction of Severity of Acute Pancreatitis Using Total Serum Calcium and Albumin-Corrected Calcium: A Prospective Study in Tertiary Center Hospital in Nepal

Prediction of Severity of Acute Pancreatitis Using Total Serum Calcium and Albumin-Corrected Calcium: A Prospective Study in Tertiary Center Hospital in Nepal

Role of Biomarkers in Diagnosis and Prognostic Evaluation of Acute Pancreatitis

Red cell distribution width and red cell distribution width to total serum calcium ratio as major predictors of severity and mortality in acute pancreatitis

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