In:
Journal of Gastroenterology and Hepatology, Wiley, Vol. 34, No. 11 ( 2019-11), p. 2043-2049
Abstract:
Local complications of acute pancreatitis (AP) carry risks of morbidity/mortality. This study aimed to assess whether urinary trypsinogen‐2 levels and Bedside Index for Severity in Acute Pancreatitis (BISAP) score on admission predicted subsequent local complications. Methods One hundred and forty‐four consecutive patients with AP were prospectively followed till 6 months after discharge. Urinary trypsinogen‐2 levels were measured within 24 h of admission. Local complications (acute peripancreatic fluid collection, acute necrotic collection, pseudocyst, and walled‐off necrosis) were diagnosed by abdominal computed tomography. Cut‐off for trypsinogen‐2 level was assessed using receiver operating characteristic curve, and predictors of local complications were analyzed by logistic regression. Results Thirty‐seven (25.7%) patients developed local complications. Urinary trypsinogen‐2 levels were significantly higher in patients with local complications compared with those without local complications (median [interquartile range], 3210 [620–9764.4] μg/L vs 627.3 [72.3–5895] μg/L, P = 0.006). Urinary trypsinogen‐2 significantly outperformed BISAP score in predicting local complications (area under the receiver operating characteristic curve 0.65 [95% CI: 0.55–0.75] vs 0.48 [95% CI: 0.38–0.58], P = 0.005). At the optimal cut‐off of 500 μg/L, the sensitivity, specificity, positive predictive value, and negative predictive value of trypsinogen‐2 level were 78.4%, 45.8%, 33.3%, and 86.0%, respectively. Urinary trypsinogen‐2 level 〉 500 μg/L was an independent predictor of local complications (adjusted odds ratio, 3.72; 95% CI: 1.42–9.76; P = 0.007). By contrast, BISAP score ≥ 3 and pleural effusion predicted organ failure but not local complications. Conclusion In a prospective cohort, urinary trypsinogen‐2 level 〉 500 μg/L independently predicted local complications of AP.
Type of Medium:
Online Resource
ISSN:
0815-9319
,
1440-1746
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
2006782-3
