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Admission serum glucose level: an accurate predictor of outcome in gallstone pancreatitis

Siraj G Rajaratnam1, Iain G Martin

  • 1Department of Surgery, Middlemore Hospital, South Auckland, New Zealand. sirajrajaratnam@hotmail.com

Pancreas
|June 29, 2006
PubMed

Insights

Elevated admission serum glucose is a simple prognostic marker for gallstone pancreatitis complications. This finding is more informative than Glasgow and APACHE II scores for predicting patient outcomes.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Clinical Prognostics

Background:

  • Early identification of high-risk patients with acute pancreatitis is crucial for effective management.
  • Currently, no simple and accurate prognostic markers are widely established for gallstone pancreatitis complications.

Purpose of the Study:

  • To evaluate the utility of admission serum glucose levels as a prognostic marker in patients with gallstone pancreatitis.
  • To compare the prognostic value of serum glucose with established scoring systems like Glasgow and APACHE II.

Main Methods:

  • Retrospective review of 184 consecutive gallstone pancreatitis admissions.
  • Recorded serum glucose, Glasgow scores, and APACHE II scores upon admission.
  • Analyzed outcomes including mortality, intensive care unit (ICU) requirement, local complications, and length of hospital stay.

Main Results:

  • Admission serum glucose ≥ 8.3 mmol/L was a significant predictor of mortality (LR 2.51), ICU admission (LR 3.23), and local complications (LR 2.61).
  • Patients with elevated glucose had a significantly longer mean hospital stay (17.9 days vs. 7.1 days).
  • Serum glucose ≥ 8.3 mmol/L demonstrated comparable or superior prognostic ability to APACHE II scores for mortality and was better for predicting complications.

Conclusions:

  • Admission serum glucose level is a valuable and simple prognostic marker in gallstone pancreatitis.
  • Elevated serum glucose provides more prognostic information than Glasgow and APACHE II scores for predicting adverse outcomes.
  • This marker can aid in early risk stratification and management of gallstone pancreatitis.
Abstract

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