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Erschienen in: Digestive Diseases and Sciences 10/2009

01.10.2009 | Original Article

Time Frames for Analysis of Inflammatory Mediators in Acute Pancreatitis: Improving Admission Triage

verfasst von: Andrés Duarte-Rojo, Jorge Suazo-Barahona, María Teresa Ramírez-Iglesias, Luis F. Uscanga, Guillermo Robles-Díaz

Erschienen in: Digestive Diseases and Sciences | Ausgabe 10/2009

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Abstract

Improving the outcome of acute pancreatitis through prognostic markers has been a matter of ample research. We evaluate the clinical usefulness of four serum markers in comparison to Ranson’s score. Serum measurements of C-reactive protein (CRP), interleukin-6, -10 (IL-6, IL-10), and pancreatitis-associated protein (PAP) were performed. The usefulness of each marker for predicting severity was compared with that of Ranson’s score. Time of evolution was considered for improving their usefulness. Seventy-one patients were studied. Severe cases had higher levels of all markers, although only IL-10 had better accuracy than Ranson’s. In patients admitted during the first 48 h, IL-6, IL-10, and PAP had improved accuracy over Ranson’s; however, after this time frame, only CRP outperformed Ranson’s score. Analysis of time frames improved the accuracy of all markers. Therefore, time of evolution should be considered when using these parameters for a better prognosis.
Literatur
2.
Zurück zum Zitat Bathia M, Brady M, Shokuhi S, Christmas S, Neoptolemos JP, Slavin J. Inflammatory mediators in acute pancreatitis. J Pathol. 2000;190:117–125. doi:10.1002/(SICI)1096-9896(200002)190:2<117::AID-PATH494>3.0.CO;2-K.CrossRef Bathia M, Brady M, Shokuhi S, Christmas S, Neoptolemos JP, Slavin J. Inflammatory mediators in acute pancreatitis. J Pathol. 2000;190:117–125. doi:10.1002/(SICI)1096-9896(200002)190:2<117::AID-PATH494>3.0.CO;2-K.CrossRef
4.
Zurück zum Zitat Leser HG, Gross V, Scheibenbogen C, et al. Elevation of interleukin-6 concentration precedes acute-phase response and reflects severity in acute pancreatitis. Gastroenterology. 1991;101:782–785.PubMed Leser HG, Gross V, Scheibenbogen C, et al. Elevation of interleukin-6 concentration precedes acute-phase response and reflects severity in acute pancreatitis. Gastroenterology. 1991;101:782–785.PubMed
5.
Zurück zum Zitat Heath DI, Cruickshank A, Gudgeon M, Jehanli A, Shenkin A, Imrie CW. Role of interleukin-6 in mediating the acute phase protein response and potential as an early means of severity assessment in acuta pancreatitis. Gut. 1993;34:41–45. doi:10.1136/gut.34.1.41.PubMedCrossRef Heath DI, Cruickshank A, Gudgeon M, Jehanli A, Shenkin A, Imrie CW. Role of interleukin-6 in mediating the acute phase protein response and potential as an early means of severity assessment in acuta pancreatitis. Gut. 1993;34:41–45. doi:10.​1136/​gut.​34.​1.​41.PubMedCrossRef
8.
Zurück zum Zitat Chen CC, Wang SS, Lu RH, Chang FY, Lee SD. Serum interleukin 10 and interleukin 11 in patients with acute pancreatitis. Gut. 1999;45:895–899.PubMedCrossRef Chen CC, Wang SS, Lu RH, Chang FY, Lee SD. Serum interleukin 10 and interleukin 11 in patients with acute pancreatitis. Gut. 1999;45:895–899.PubMedCrossRef
10.
Zurück zum Zitat Keim V, Iovanna JL, Dagorn JC. The acute phase reaction of the exocrine pancreas. Gene expression and synthesis of Pancreatitis-Associated-Proteins. Digestion. 1994;55:65–72.PubMedCrossRef Keim V, Iovanna JL, Dagorn JC. The acute phase reaction of the exocrine pancreas. Gene expression and synthesis of Pancreatitis-Associated-Proteins. Digestion. 1994;55:65–72.PubMedCrossRef
13.
Zurück zum Zitat Bradley EL. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on acute pancreatitis, Atlanta, Sept. 11–13, 1992. Arch Surg. 1993;128:586–590.PubMed Bradley EL. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on acute pancreatitis, Atlanta, Sept. 11–13, 1992. Arch Surg. 1993;128:586–590.PubMed
14.
Zurück zum Zitat Zweig MH, Campbell G. Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem. 1993;39:561–577.PubMed Zweig MH, Campbell G. Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem. 1993;39:561–577.PubMed
15.
Zurück zum Zitat Fletcher RH, Fletcher SW, Wagner EH. Diagnosis. In: Collins N, Eckhart C, Chalew GN, eds. Clinical epidemiology: the essentials. 3rd Ed. Philadelphia: Lippincott Williams & Wilkins; 1995:43–74. Fletcher RH, Fletcher SW, Wagner EH. Diagnosis. In: Collins N, Eckhart C, Chalew GN, eds. Clinical epidemiology: the essentials. 3rd Ed. Philadelphia: Lippincott Williams & Wilkins; 1995:43–74.
16.
Zurück zum Zitat Glantz SA. Primer of biostatistics. 4th ed. New York: McGraw-Hill; 1997. Glantz SA. Primer of biostatistics. 4th ed. New York: McGraw-Hill; 1997.
17.
Zurück zum Zitat Duarte-Rojo A, Lezama-Barreda A, Ramírez-Iglesias MT, Peláez-Luna M, Robles-Díaz G. Is leptin related to systemic inflammatory response in acute pancreatitis? World J Gastroenterol. 2006;12:4392–4396.PubMed Duarte-Rojo A, Lezama-Barreda A, Ramírez-Iglesias MT, Peláez-Luna M, Robles-Díaz G. Is leptin related to systemic inflammatory response in acute pancreatitis? World J Gastroenterol. 2006;12:4392–4396.PubMed
18.
Zurück zum Zitat Pezzilli R, Billi P, Miniero R, et al. Serum interleukin-6, interleukin-8, and beta 2-microglobulin in early assessment of severity of acute pancreatitis. Comparison with C-reactive protein. Dig Dis Sci. 1995;40:2341–2348. doi:10.1007/BF02063235.PubMedCrossRef Pezzilli R, Billi P, Miniero R, et al. Serum interleukin-6, interleukin-8, and beta 2-microglobulin in early assessment of severity of acute pancreatitis. Comparison with C-reactive protein. Dig Dis Sci. 1995;40:2341–2348. doi:10.​1007/​BF02063235.PubMedCrossRef
19.
Zurück zum Zitat Pezzilli R, Billi P, Migliori M, Gullo L. Clinical value of pancreatitis-associated-protein in acute pancreatitis. Am J Gastroenterol. 1997;92:1887–1891.PubMed Pezzilli R, Billi P, Migliori M, Gullo L. Clinical value of pancreatitis-associated-protein in acute pancreatitis. Am J Gastroenterol. 1997;92:1887–1891.PubMed
20.
Zurück zum Zitat Iovanna JL, Keim V, Nordback I, et al. Serum levels of Pancreatitis-Associated-Protein as indicators of the course of acute pancreatitis. Gastroenterology. 1994;106:728–734.PubMed Iovanna JL, Keim V, Nordback I, et al. Serum levels of Pancreatitis-Associated-Protein as indicators of the course of acute pancreatitis. Gastroenterology. 1994;106:728–734.PubMed
22.
Zurück zum Zitat Brivet FG, Emilie D, Galanaud P. Pro- and anti-inflammatory cytokines during acute severe pancreatitis: an early and sustained response, although unpredictable of death. Parisian Study Group on Acute Pancreatitis. Crit Care Med. 1999;27:749–755. doi:10.1097/00003246-199904000-00029.PubMedCrossRef Brivet FG, Emilie D, Galanaud P. Pro- and anti-inflammatory cytokines during acute severe pancreatitis: an early and sustained response, although unpredictable of death. Parisian Study Group on Acute Pancreatitis. Crit Care Med. 1999;27:749–755. doi:10.​1097/​00003246-199904000-00029.PubMedCrossRef
24.
Zurück zum Zitat Suazo-Baráhona J, Carmona-Sánchez R, Robles-Díaz G, et al. Obesity: a risk factor for severe acute biliary and alcoholic pancreatitis. Am J Gastroenterol. 1998;93:1324–1328.PubMed Suazo-Baráhona J, Carmona-Sánchez R, Robles-Díaz G, et al. Obesity: a risk factor for severe acute biliary and alcoholic pancreatitis. Am J Gastroenterol. 1998;93:1324–1328.PubMed
Metadaten
Titel
Time Frames for Analysis of Inflammatory Mediators in Acute Pancreatitis: Improving Admission Triage
verfasst von
Andrés Duarte-Rojo
Jorge Suazo-Barahona
María Teresa Ramírez-Iglesias
Luis F. Uscanga
Guillermo Robles-Díaz
Publikationsdatum
01.10.2009
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 10/2009
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-008-0615-1

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