Prediction of Severity of Acute Pancreatitis Using Total Serum Calcium and Albumin-Corrected Calcium: A Prospective Study in Tertiary Center Hospital in Nepal.

Ashik Pokharel,Suman Phuyal,Prem Raj Sigdel,Pradeep Vaidya,Prasan Bir Singh Kansakar

doi:10.1155/2017/1869091

Abstract

Introduction Total calcium (TC) and albumin-corrected calcium (ACC) are easily accessible AP severity tests in the Primary Health Care Center of Nepal. The aim of the study was to evaluate TC and ACC as prognostic severity markers in acute pancreatitis (AP). Methods All patients admitted in Tribhuvan University Teaching Hospital with the diagnosis of AP were studied prospectively over a period of one year from January 2015 to January 2016. TC and ACC were measured in the first 24 hours of admission in each patient. The modified Marshall score was determined at admission and at 48 hours and at any point of time during admission as per the need of the patient. Severity of acute pancreatitis was defined as per the Revised Atlanta Classification 2012. Results 80 patients of AP were included in the study. Among them, 14% were categorized as having severe AP. The mean total calcium was 8.22, 7.51, and 6.98 for mild, moderate, and severe AP, respectively, which was significant at 0.001. Conclusion TC and ACC, measured within the first 24 hours, are useful severity predictors in acute pancreatitis.

Highlights

Total calcium (TC) and albumin-corrected calcium (ACC) are accessible Acute pancreatitis (AP) severity tests in the Primary Health Care Center of Nepal. e aim of the study was to evaluate TC and ACC as prognostic severity markers in acute pancreatitis (AP)
E 1992 Atlanta guidelines was the rst clinically based and universally applicable classi cation which de ned the severity and the complications of AP [2]. e Atlanta classi cation was revised in the year 2012, which categorizes AP into 3 states: mild, moderate, and severe based on the presence of organ failure or local complications [3]. e organ failure is determined by the modi ed Marshall scoring system [4]
Forty-six patients (58%) who presented with acute pancreatitis were female, whereas thirtyfour (42%) were male. 55 (69%) of the patients belonged to the mild group, 14 (17.0%) in moderately severe group, and 11 (14.0%) in severe group

Summary

Introduction

Total calcium (TC) and albumin-corrected calcium (ACC) are accessible AP severity tests in the Primary Health Care Center of Nepal. e aim of the study was to evaluate TC and ACC as prognostic severity markers in acute pancreatitis (AP). In approximately one-third of the patients, acute severe pancreatitis may develop, producing progressive organ dysfunction usually caused by a rapidly progressive in ammatory response, which is associated with a prolonged hospital stay and signi cant morbidity and mortality. E Atlanta classi cation was revised in the year 2012, which categorizes AP into 3 states: mild, moderate, and severe based on the presence of organ failure or local complications [3]. Total calcium and albumin-corrected calcium are simpli ed markers that can be readily measured and can be calculated and interpreted by any health persons. It has been evaluated as a mortality prognostic factor and has been evaluated as a predictor of severe AP with infection. Albumin-corrected calcium has been associated with severity [5]

Methods

Results

Discussion

Conclusion