engleski

Serum creatinine, urea nitrogen and hematocrite in the early detection of pancreatic necrosis

INTRODUCTION: Pancreatic necrosis is a serious local complication of acute pancreatitis associated with worse clinical outcome and higher mortality. AIMS & METHODS: The main focus of our study was to identify predictive value of serum creatinine, urea nitrogen and hematocrit in early detection of pancreatic necrosis in patients with acute pancreatitis.We analyzed 97 patients with moderate to severe acute pancreatitis defined by an APACHE II score of 6 and more. All subjects performed computerized tomography (CT) between days 4 and 7 of admission with the calculation of CTSI score. Values of serum creatinine, urea nitrogen and hematocrit were assessed on admission and on days 2 and 3. We calculated the intravenous fluid resuscitation volume for each patient on admission and within 72 h of admission. RESULTS: Of 97 included patients, 24 (25%) developed pancreatic necrosis. Low serum hematocrit on admission showed a negative predictive value of 82%, while no significant results were obtained for serum creatinine and urea nitrogen. ROC curves for pancreatic necrosis revealed an area under the curve of 0.67 for admission hematocrit, 0.44 for peak creatinine, and 0.48 for peak urea nitrogen. Binary logistic regression retrieved no significant association between the three tests and pancreatic necrosis. We found that patients who developed pancreatic necrosis received a significantly higher volume of intravenous fluid resuscitation within the first 24 h (P<0.005). CONCLUSION: We confirmed that a low admission hematocrit is associated with a low incidence of pancreatic necrosis. Our results don't suggest significant association of serum creatinine and urea nitrogen values with the development of pancreatic necrosis.

Creatinine; urea nitrogen; hematocrite; acute pancreatitis; severity

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