engleski

Serum elastase on the third day is a valuable predictor of systemic complications in patients with acute pancreatitis

Introduction: Serum pancreatic elastase (E1) concentration rises significantly in acute pancreatitis (AP). Many studies confirmed that E1 has no value in prediction of complications on the first day. However, only few studies have shown its significance in prediction of severe disease cases on the third day. Objectives: To evaluate the use and accuracy of E1 in the prediction of severity of AP. Patients and Methods: In 156 admitted to our hospital with a confirmed diagnosis of AP, we measured E1 on the first and third day upon admission. Measurements were performed by immunoenzymometric principles, and refferent values were as determined by the manufacturer (<3.5 ng/ml). Statistical analysis was performed using Mann-Whitney test and ROC analysis. Results: We confirmed a statistically significant decrease of E1 between the first (median = 5.9, 95% CI 4.3–7.5), and third (median = 1.8, 95% CI 1.6–2.2) day (p < 0.001). We did not find a significant difference in E1 values on the first day between patients with and without complications (p = 0.249). However, a significant difference occurred on the third day (1.7, 95% CI 1.4–1.9 vs. 2.5, 95% CI 2.1–5.1 ; p < 0.001). ROC analysis was performed for the latter and confirmed a significant decrease of E1 in patients with complications on the third day (AUC 0.70 ; 95% CI 0.62–0.77 ; cut-off = 1.5 ; sensitivity 93% ; specificity 43%, PPV 27% ; NPV 96% ; p < 0.001). Conclusions: Our results showed that the decrease of E1 concentrations on the third day are significantly correlated with severe cases of AP and a higher rate of systemic complications.

Elastase; acute pancreatitis; severity

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