Serum creatinine and chest radiographs in the early assessment of acute pancreatitis

Practice Guidelines in Acute Pancreatitis

“…Overall, 85% of patients have interstitial pancreatitis; 15% (range 4-47%) have necrotizing pancreatitis (25,44,46,50,68,83,86,128,140,169). Among patients with necrotizing pancreatitis, 33% (range 16-47%) have infected necrosis (62,66,68,83,91,111,113,117,118,120,121,147,159,169,170).…”

“…Several reports have pointed out that a pleural effusion obtained on chest X-ray within the first 24 h of admission correlates with greater severity in terms of necrosis or organ failure (84) or greater mortality (75,86). Additionally, the presence of infiltrates on chest X-ray within 24 h has been associated with greater mortality (75,85,86).…”

“…Additionally, the presence of infiltrates on chest X-ray within 24 h has been associated with greater mortality (75,85,86).…”

The management of the patient with acute pancreatitis: from evidence to clinical practice

“…Low specificity associated with low prevalence of severe AP translate into low positive predictive values. 82 Table 1 31,[83][84][85][86][87][88][89][90][91][92][93][94][95][96][97][98][99][100][101] shows the clinical predictors, laboratory and radiological findings of acute pancreatitis gravity.…”

“…variously tested in several clinical A meta-analysis 85 with 739 patients studies 94,95 to predict the severity of the estimated: OR 2.9 (95% CI 1.8 to 4.6) AP, including: urinary trypsinogen for serious AP; OR 2.3 (95% CI 1.4 to 3.8) activation peptide, procalcitonin, for systemic complications; amylase, lipase, polymorphonuclear OR 3.8 (95% CI 2.4 to 6.6) for local elastase, pancreatic-associated protein, complications; OR, 2.1 (95% CI 1.0 to 4.8) serum glucose, serum calcium, for mortality pro-carboxypeptidase B, carboxypeptidase B activation peptide, serum trypsinogen-2, phospholipaseA-2, serum amyloid protein-A, substance P, antithrombin III, platelet activating factor, interleukins 1, 6, and 8, tumor necrosis factor-alpha or soluble tumor necrosis factor receptor, many of which are not even available for daily use, and therefore they will not be considered due to their unproven clinical utility Short time interval between start of the symptoms and hospitalization A time interval less than 24 h is associated with increased severity of pancreatitis 86 …”