Serum Creatinine Level and APACHE-II Score within 24 h of Admission Are Effective for Predicting Persistent Organ Failure in Acute Pancreatitis

Abstract

Aim. The present study was aimed at comparing serum markers and APACHE-II score to predict persistent organ failure (POF) in early acute pancreatitis (AP). Methods. In this retrospective study, data from 6024 patients with AP were included within 24 h of their admission. Serum levels of urea nitrogen (BUN), creatinine, glucose, and hematocrit and APACHE-II score were analyzed for patients with AP. We employed the area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, and specificity analyses to evaluate the accuracy of the studied laboratory parameters and APACHE-II score. Results. Our study included 2090 (35%) patients out of 6024 patients who were evaluated within 24 h of hospital admission. For predicting POF, serum creatinine level≥1.8 mg/dl had the highest specificity (98%). The second classification tree has shown that when the serum creatinine level>1.8 and APACHE−II≥8 within 24 h were combined, the rates of predicted persistent organ failure achieved 66.7%. Conclusions. In this large, hospital-based retrospective study, we demonstrated that an APACHE-II score≥8 and a serum creatinine level≥1.8 mg/dl within 24 h of admission can positively predict POF in AP and that serum creatinine levels<1.8 mg/dl within 24 h of admission can be useful for negatively predicting POF in AP.

Nomogram for the prediction of in-hospital incidence of acute respiratory distress syndrome in patients with acute pancreatitis

“…Elevated SCR as an indicator of acute kidney injury (AKI) was associated with pancreatic necrosis, organ failure and mortality in AP as well[22, 23]. Early change especially in the first 24 hours after admission in SCR level was an effective predictor of disease severity in AP[24].…”

Hematological and biochemical response in the blood of Alburnus tarichi (Actinopterygii: Cypriniformes: Cyprinidae) exposed to tebuconazole

“…The study presented is compatible with previous studies on toxic substances. Previous studies have reported that changes in the serum creatinine level are indicators of toxicity and mortality (Muddana et al 2009, Liew et al 2019, 2015, Santos Silva et al 2018, Wan et al 2019. In one study, the serum creatinine level at 48 h was considered an extremely accurate determinant of pancreatic necrosis (Wan et al 2019).…”

“…Previous studies have reported that changes in the serum creatinine level are indicators of toxicity and mortality (Muddana et al 2009, Liew et al 2019, 2015, Santos Silva et al 2018, Wan et al 2019. In one study, the serum creatinine level at 48 h was considered an extremely accurate determinant of pancreatic necrosis (Wan et al 2019). The presently reported study supports this situation because the creatinine level increased significantly after 48 h. When the kidney or liver is damaged, the urea level may begin to rise (Llopis-Lorente et al 2019).…”

An Artificial Neural Networks Model for Early Predicting In-Hospital Mortality in Acute Pancreatitis in MIMIC-III

“…In this study, twelve variables including age, ALT, total bilirubin, CK-Mb, PT, WBC, amylase, total calcium, creatinine, HCT, lactate, and lipase which were identified to be significant difference by univariate analysis were set as the input layers, and the most important four variables including total bilirubin, amylase, ALT and creatine were identified, which also were reported in other studies. Evidence showed that the levels of total bilirubin and ALT were significantly higher in AP patients with a Ranson score ≥3 [ 23 ], and early elevated creatinine within 24 hours after admission was a good predictor of fatal outcomes in AP patients [ 24 ]. Serum level of amylase was not only for AP diagnosis but also associated with severity and prognosis of AP [ 25 , 26 ].…”