Early identification of patients at high risk of complications from acute pancreatitis is important.
As yet, no simple and accurate method has been identified.
Dr Siraj Rajaratnam and colleagues evaluated admission serum glucose as a prognostic marker in gallstone pancreatitis.
The team retrospectively reviewed consecutive admissions with gallstone pancreatitis to a large urban hospital.
The investigative team recorded serum glucose levels, Glasgow scores, and Acute Physiology and Chronic Health Evaluation II scores.
Outcomes considered were death, intensive care requirement, local complications, and length of hospital stay.
|The risk of complications increased with glucose levels of 8.3 mmol/L or higher |
The investigators assessed a total of 184 admissions, of which 122 were women, and 62 were men with a mean age of 55 years.
The team found that a serum glucose of 8.3 mmol/L or more was as good as Acute Physiology and Chronic Health Evaluation II score of 8 or above in predicting mortality.
Overall, 9% of the patients were admitted to intensive care units.
Risk was significantly higher in patients with glucose of 8.3 mmol/L or higher or Acute Physiology and Chronic Health Evaluation II score of 8 or above.
Local complications occurred in 12% of the patients.
The team noted that the risk of complications significantly increased in patients with glucose of 8.3 mmol/L or higher.
The risk of complications also increased with higher Acute Physiology and Chronic Health Evaluation II or Glasgow scores.
Patients with admission serum glucose of 8.3 mmol/L or higher had a mean length of stay of 18 days.
The investigators observed that patients with admission serum glucose of less than 8.3 mmol/L had a mean length stay of 7 days.
Dr Rajaratnam's team concluded, “In gallstone pancreatitis, an elevated admission serum glucose level offers more prognostic information than Glasgow and Acute Physiology and Chronic Health Evaluation Acute Physiology and Chronic Health Evaluation II scores.”