FIRST DAY SERUM ALBUMIN, AN INDEPENDENT PREDICTOR OF MORTALITY IN PATIENTS WITH ACUTE ALCOHOLIC PANCREATITIS

Abstract

Purpose: Prognostic criteria have been described for acute pancreatitis. The aim of this study was to identify other useful predictors of mortality among patients with acute alcoholic pancreatitis. Methods: Data was prospectively collected on 299 hospitalized patients with acute alcoholic pancreatitis from 1982–2000 with a mean age of 42.4 ± 12.4 years and mean length of stay of 11.6 ±11.3 days. The sample included 208 males and 91 females. Eight patients died during hospitalization. CT scan grade (A-E), general chemistry lab data, month, season, and year of hospitalization were examined. These variables, their increasing/decreasing trends plus valuable set points during the initial 48 hours of hospitalization were evaluated in a series logistic regression model to predict death during hospitalization. Results: Patients who died were older (p = 0.0018), had higher Ranson's score (p = 0.0101), increased BUN (p = 0.0022), and a lower albumin (p = 0.0014) than patients who survived. Our study describes an independent 60-fold increased risk of death when albumin levels were less than 2.5 g/dL (p = 0.001) on the first day of hospitalization. Conclusions: Serum albumin on admission is an independent predictor of outcome in acute alcoholic pancreatitis. It is not clear whether the low albumin level represents protein-calorie malnutrition or a decline as a consequence of acute pancreatitis.