Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 22 November 2017

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Soluble thrombomodulin plasma levels can predict lethality in acute pancreatitis

Soluble thrombomodulin plasma levels are an early indication of a lethal course in human acute pancreatitis, finds a study published in the April issue of Surgery.

News image

fiogf49gjkf04

A team from Magdeburg and Aachen, Germany, investigated the potential to predict severe disease and lethality in acute pancreatitis, by using plasma soluble thrombomodulin (sTM) and C-reactive protein (CRP) levels.

A total of 73 patients with acute pancreatitis were enrolled in the prospective study.

According to the Atlanta criteria, pancreatitis was classified as mild in 23 patients and as severe in 50 patients.

Blood was collected on days 1, 3, 5, 7, 10, 14, 21, and 28 after the onset of pain, and was analyzed for sTM and CRP.

Most of the admissions occurred between days 3 and 10 of acute pancreatitis.

During this period, sTM levels at a cutoff of 75 ng/ml on day 3 and 71 ng/ml on day 10 were predictive of a lethal outcome.

Both of these cutoff levels had a sensitivity of 100%, a specificity of 77%, and a negative predictive value of 100%.

However, the positive predictive value was slightly lower when using the sTM level on day 3 (38% vs 41%).

sTM levels predict acute pancreatitis patients who are at most risk of dying.
Surgery

With sTM levels, it was not possible to differentiate patients with mild pancreatitis from those with severe pancreatitis.

In contrast, CRP levels at a cutoff of 113 mg/l on day 3 differentiated severe from mild courses with a diagnostic sensitivity of 84%, a specificity of 60%, a positive predictive value of 78%, and a negative predictive value of 69%.

CRP levels at a cutoff of 122 mg/L on day 10 differentiated mild from severe courses (nonsurvivors) with a diagnostic sensitivity of 72%, a specificity of 72%, a positive predictive value of 86%, and a negative predictive value of 53%.

In contrast, differentiation of mild forms of acute pancreatitis from severe pancreatitis (survivors) on day 10 was not possible.

Dr Rene Mantke, of the Otto-von-Guericke-University of Magdeburg, said on behalf of fellow authors, "CRP is a valuable marker of disease severity in acute pancreatitis, especially in the first period of pancreatitis.

"On the other hand, sTM identifies early those patients with the most severe courses and a high risk of dying.

"Determination of sTM, in addition to CRP, offers the opportunity of identifying early those patients who require intensive care most urgently."

"Of course, further investigations of sTM in acute pancreatitis are indicated to confirm our results," it was concluded.

Surgery 2002; 131: 424-32
12 April 2002

Go to top of page Email this page Email this page to a colleague

 22 November 2017 
Surgical treatment delays influence survival in colon cancer
 22 November 2017 
Golimumab in Crohn's disease
 22 November 2017 
Challenges of US-trained gastroenterologists when abroad
 21 November 2017 
Prepregnancy obesity and maternal mortality
 21 November 2017 
Preoperative optimization in IBD patients
 21 November 2017 
Cholangiopathy in critically ill patients
 20 November 2017 
Socioeconomic characteristics in diverticular disease
 20 November 2017 
Barriers to hepatitis C treatment
 20 November 2017 
Endoscopic indices of disease activity for Crohn’s
 17 November 2017 
Food elimination diets for treatment of adults with eosinophilic esophagitis
 17 November 2017 
PPI use and cognitive function in women
 17 November 2017 
Predicting microscopic colitis
 16 November 2017 
NAFLD-hepatocellular carcinoma and survival after orthotopic liver transplant
 16 November 2017 
Prepregnancy obesity and severe maternal morbidity
 16 November 2017 
Celiac disease screening in adult first-degree relatives
 15 November 2017 
Breastfeeding and the risk of IBD
 15 November 2017 
Predicting recurrence after curative rectal cancer surgery
 15 November 2017 
Medication nonadherence and health care costs
 14 November 2017 
Eosinophilic gastroenteritis and colitis
 14 November 2017 
HBV/HCV coinfection and cirrhosis
 14 November 2017 
Sexual dysfunction after rectal cancer surgery
 13 November 2017 
Flares after immunomodulator withdrawal in Crohn's
 13 November 2017 
Genetic polymorphisms, fatty acids and ulcerative colitis
 13 November 2017 
GI bleeding in patients taking non–vitamin K antagonist oral anticoagulants
 10 November 2017 
Thiopurines vs TNF and lymphoma risk in IBD
 10 November 2017 
Drug monitoring of anti-tumour necrosis factor therapy in IBD
 10 November 2017 
Treatment decisions for older patients with colorectal cancer
 09 November 2017 
Quality standards in upper gastrointestinal endoscopy
 09 November 2017 
Irradiated rectal cancer and chemoradiotherapy
 09 November 2017 
Environmental factors and IBD
 08 November 2017 
Prophylaxis of spontaneous bacterial peritonitis
 08 November 2017 
Optimal management of postoperative Crohn's disease
 07 November 2017 
Community Screening for Helicobacter pylori
 07 November 2017 
Early readmission in IBD patients
 07 November 2017 
Mesocolic excision for colon cancer
 06 November 2017 
Food elimination diet for children with eosinophilic esophagitis
 06 November 2017 
Biologic agents and obesity in children with IBD
 06 November 2017 
Liver cancer burden despite extensive use of antiviral agents
 03 November 2017 
Statins and mortality in chronic viral hepatitis
 03 November 2017 
Propofol for outpatient colonoscopy
 03 November 2017 
Asthma and IBD development
 02 November 2017 
Diverticulitis and emergency department burden
 02 November 2017 
Rural residence and risk of IBD
 02 November 2017 
Sexual functioning in Hep C
 01 November 2017 
Heartburn relief in adolescents with GERD
 01 November 2017 
Autoimmune pancreatitis in children
 31 October 2017 
Follow-up of positive results on fecal blood tests
 31 October 2017 
Surveillance in ulcerative colitis and Crohn’s disease
 30 October 2017 
Local recurrence after curative rectal cancer surgery
 30 October 2017 
Low-flow ascites pump in refractory cirrhosis
 30 October 2017 
Medical therapy of patients with pediatric-onset IBD
 27 October 2017 
NAFLD in advanced fibrosis in the USA
 27 October 2017 
Early readmission in cirrhosis after bacterial infections
 26 October 2017 
Predicting response to anti-TNF therapy in Crohn's
 26 October 2017 
Conversion to open laparotomy in rectal cancer
 25 October 2017 
Conversion of colonoscopy to sigmoidoscopy
 25 October 2017 
Rifaximin and survival in hepatic encephalopathy
 25 October 2017 
Fecal microbiota transplantation
 24 October 2017 
Eosinophilic esophagitis with swallowed topical corticosteroids
 24 October 2017 
Meta-analysis in nutritiona research

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2017 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us