Is there correlation between pancreatic enzyme and radiological severity in acute pancreatitis?

Table 1 Characteristics of each group (%)

	Total	G-1	G-2	G-3
Sex
Male	83 (69.7)	8 (23.5)	30 (25.2)	25 (21.0)
Female	36 (30.3)	13 (10.9)	16 (13.4)	7 (6.0)
Mean age (yr)	55.7 ± 15.7	51.2 ± 15.3	62.4 ± 14.6	51.9 ± 14.8
Etiology
Biliary	49	21 (42.9)	21 (42.9)	7 (14.2)
Alcoholic	46	8 (17.0)	19 (41.3)	19 (41.3)
Drug	3	2 (67.0)	0 ( 0.0)	1 (33.3)
Idiopathic	21	10 (47.6)	6 (28.6)	5 (23.8)
Radiologic grade		41 (34.3)	46 (38.6)	32(26.8)

G-1: Balthazar CT grade A, B; G-2: Balthazar CT grade C; G-3: Balthazar CT grade D, E.

Table 2 Serum pancreatic enzyme (at initial) according to etiology

	Amylase	Lipase	L/A ratio
Alcohol	614 ± 466.9	2227.2 ± 1988.8	4.3 ± 2.4
Biliary	1107.6 ± 1185.9	3561.6 ± 3023.8	3.9 ± 2.0
Drug	427 ± 273.5	1320.3 ± 811.7	3.1 ± 0.1
Idiopathic	893 ± 1026.9	2481.9 ± 2983.9	3.6 ± 2.5

Reference values: Total amylase 13-65 IU/L, lipase 0-200 IU/L.

Table 3 Univariate analysis of predictive factors

	G-1	G-2	G-3	P-value
BMI	2.5 ± 0.7	2.3 ± 0.7	2.2 ± 0.6	0.16
Leukocytosis (/mm3)	11 249.0 ± 6964.3	10 555.0 ± 4212.5	17 700.6 ± 23 913.3	0.048a
Hemoglobin (g/dL)	13.7 ± 1.9	13.4 ± 2.1	14.8 ± 2.3	0.016a
Platelet (103/mm2)	223.3 ± 92.1	220.5 ± 61.2	232.0 ± 95.8	0.829
AST (IU/L)	233.2 ± 253.9	337.9 ± 645.8	176.3 ± 393.7	0.31
ALT (IU/L)	212.0 ± 221.8	201.5 ± 235.2	139.2 ± 237.9	0.368
Total bilirubin (mg/dL)	2.8 ± 2.2	2.2 ± 1.9	1.5 ± 1.1	0.023a
Albumin (g/dL)	3.9 ± 0.4	3.8 ± 0.4	3.8 ± 0.6	0.51
S-amylase (IU/L)	768.3 ± 926.4	762.7 ± 517.3	1243.1 ± 1531.7	0.079
S-lipase (IU/L)	1944.2 ± 1560.4	2820.3 ± 2521.4	3862.8 ± 3586.6	0.009a
Ranson (initial)	1.7 ± 1.3	2.1 ± 1.2	1.8 ± 1.1	0.272
Ranson	0.7 ± 0.7	1.2 ± 1.0	0.9 ± 0.9	0.052
(24 h after)
A PACH-II (initial)	4.8 ± 4.3	7.5 ± 4.3	6.0 ± 4.5	0.017a
APACH-II (24 h after)	3.5 ± 3.0	5.5 ± 3.8	4.7 ± 3.8	0.031a
CRP (initial) (mg/dL)	4.5 ± 5.2	5.5 ± 4.5	11.9 ± 7.1	0.000a
CRP (f/u)	2.4 ± 3.7	2.4 ± 2.5	6.6 ± 5.5	0.003a

^aP < 0.05.

Table 4 Multivariate analysis of predictive factors

Factors	P value
Leukocytosis	0.29
Hemoglobin	0.07
Total bilirubin	0.31
S-lipase	0.44
APACH-II (initial)	0.65
APACH-II (24 h after)	0.47
CRP (initial)	0.001a
CRP (f/u)	0.004a

^aP < 0.05.

Table 5 Likelihood ratio for prognostic markers at two time intervals

Marker	Initial	24 h after
CRP	2.22/0.39	2.09/0.46
Ranson	1.22/0.71	1.09/0.87
APACH-II	1.23/0.70	1.01/1.00

Positive likelihood ratio/negative likelihood ratio; Positive likelihood ratio = sensitivity/(1-specificity); Negative likelihood ratio = (1-sensitivity)/specificity.

Table 6 CRP test

Cut-off value	8.3	5.8	2.7
Sensitivity	70.6%	73.5%	69.6%
Specificity	81.6%	68.4%	68.7%
Likelihood for positive test	3.84	2.33	2.22
Likelihood for negative test	0.26	0.44	0.45

CRP: C-reactive protein (reference value: 0-5 mg/L).