Bidari Subodh Kumar, Dhungana Milan, Panthi Ram Chandra, Joshi Kushal Raj, Shrestha Ritika, Neupane Dinesh, Khanal Gurbi, Lama Mipsang, Kayastha Gyan Krishna
Internal Medicine, Patan Academy of Health Sciences, Lalitpur, NPL.
Internal Medicine, Universal College of Medical sciences, Bhairahawa, NPL.
Cureus. 2024 Sep 3;16(9):e68527. doi: 10.7759/cureus.68527. eCollection 2024 Sep.
Background and objective Acute pancreatitis (AP) is a frequent cause of hospitalization for gastrointestinal issues, with a significant proportion of cases requiring intensive care. Although various scoring systems are available to predict AP severity, they often involve inconvenience and can be time-consuming and expensive. Hematocrit, a simple, cost-effective, readily available hematological test, has been used to predict AP severity. However, its effectiveness has been inconsistent across different studies. In light of this, we aimed to analyze the role of hematocrit levels in determining AP severity. Methods We conducted a prospective study at Patan Hospital in Lalitpur, Nepal, from June 8, 2022, to June 27, 2023. Sixty-five AP patients were evaluated to determine the prognostic value of hematocrit at admission. The severity of AP was classified per the Revised Atlanta Classification. Results Among the patients, 52 (80%) had mild AP (MAP), five (7.69%) had moderately severe AP (MSAP), and eight (12.31%) had severe AP (SAP). The receiver operating characteristic (ROC) curve for admission hematocrit levels yielded an area under the curve (AUC) of 0.551 (95% CI: 0.423-0.675). A hematocrit cutoff value of 42% resulted in a sensitivity of 69.23% and a specificity of 46.15% for predicting severe AP (MSAP + SAP). Conclusions Based on our findings, hematocrit at admission is not a strong predictor of the severity of AP.
背景与目的 急性胰腺炎（AP）是胃肠道疾病住院治疗的常见原因，相当一部分病例需要重症监护。尽管有多种评分系统可用于预测AP的严重程度，但它们往往不便使用，且可能耗时且昂贵。血细胞比容是一种简单、经济高效且易于获得的血液学检测指标，已被用于预测AP的严重程度。然而，其有效性在不同研究中并不一致。有鉴于此，我们旨在分析血细胞比容水平在确定AP严重程度中的作用。方法 我们于2022年6月8日至2023年6月27日在尼泊尔拉利特布尔的帕坦医院进行了一项前瞻性研究。对65例AP患者进行评估，以确定入院时血细胞比容的预后价值。AP的严重程度根据修订的亚特兰大分类进行分类。结果 在这些患者中，52例（80%）患有轻度AP（MAP），5例（7.69%）患有中度重症AP（MSAP），8例（12.31%）患有重症AP（SAP）。入院时血细胞比容水平的受试者工作特征（ROC）曲线下面积（AUC）为0.551（95%CI：0.423 - 0.675）。血细胞比容临界值为42%时，预测重症AP（MSAP + SAP）的敏感性为69.23%，特异性为46.15%。结论 根据我们的研究结果，入院时的血细胞比容不是AP严重程度的有力预测指标。
