Original Contribution | Published:

Hemoconcentration as an early risk factor for necrotizing pancreatitis

American Journal of Gastroenterology volume 93, pages 21302134 (1998) | Download Citation

Subjects

Abstract

Objective:

The aim of our study was to determine whether measurement of serum hematocrit during the first 24 h helps in distinguishing necrotizing from mild pancreatitis.

Methods:

From May 1992 to June 1996, a case-control study was performed with cases of patients with necrotizing pancreatitis. We selected as a control the next patient admitted with mild pancreatitis.

Results:

There were 32 patients in each group. Logistic regression identified an admission hematocrit of ≥ 47% and a failure of admission hematocrit to decrease at 24 h as the best binary risk factors for necrotizing pancreatitis. At admission, more patients with necrotizing pancreatitis than with mild pancreatitis had a hematocrit ≥ 47% (11/32 vs 3/32; p= 0.03). At 24 h, 15 additional patients with necrotizing pancreatitis versus only one with mild pancreatitis showed no decrease in admission hematocrit (p < 0.01). Thus, by 24 h, 26 of 32 patients with necrotizing pancreatitis versus only four of 32 patients with mild pancreatitis met one or the other criterion (p < 0.01). The sensitivity and specificity at admission were 34% and 91%; at 24 h, 81% and 88%.

Conclusions:

Hemoconcentration with an admission hematocrit ≥ 47% or failure of admission hematocrit to decrease at approximately 24 h were strong risk factors for the development of pancreatic necrosis.

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Affiliations

  1. Center for Pancreatic Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA

    • Jean-Daniel Baillargeon
    • , John Orav
    • , Vinodhini Ramagopal
    • , ScottM Tenner
    •  & Peter A Banks

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Corresponding author

Correspondence to Peter A Banks.

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DOI

https://doi.org/10.1111/j.1572-0241.1998.00608.x

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