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Analysis of Elevated Serum Amylases, Lipase Levels in Neurointensive Care Unit Based on Abdominal CT Scan

Journal of Neurointensive Care 2020년 3권 2호 p.58 ~ 63
박무승, 양진서, 최혁재, 전진평, 강숙형, 조영준,
소속 상세정보
박무승 ( Park Mu-Seung ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery
양진서 ( Yang Jin-Seo ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery
최혁재 ( Choi Hyuk-Jai ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery
전진평 ( Jeon Jin-Pyeong ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery
강숙형 ( Kang Suk-Hyung ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery
조영준 ( Cho Yong-Jun ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery

Abstract


Objective: To evaluate the clinical characteristics of patients in neurointensive care unit (NICU) whose pancreatic enzyme has elevated and the appropriate cut off value of amylase, lipase for conducting the computerized tomography (CT) scans.

Methods: This was retrospective study of 66 patients in NICU unit who had elevated pancreatic enzymes from January 2008 to December 2013. We classified the subjects with two groups according to CT findings of pancreas ? Balthazar score. Patients’ demographic and clinical data was analyzed and level of amylase, lipase was evaluated using receiver operating characteristics curve.

Results: The patients were categorized into 2 groups according to CT findings. Morphologic alteration of pancreas was classified in Group 1, and normal pancreas in CT findings was classified in Group 2. There were no statistical differences between groups, but peak serum lipase level was elevated in Group 1 with statistical significance (p=0.032). By receiver operating characteristics (ROC) curve, we could suspect pancreatitis more precisely in patients with elevated amylase levels > 2-fold the upper normal limit (207 U/L, 73.3% sensitivity and 60.6% specificity), or elevated lipase levels > 4-fold the upper normal limit (1243 U/L, 80% sensitivity and 60.6% specificity) calculated by maximum of the Youden index.

Conclusions: According to our results, serum lipase level is more significant value for pancreatitis. And abdominal CT should be considered if patient’s amylase levels are more than 2-fold and lipase levels are more than 4-fold.

키워드

Pancreatitis; Amylases; Lipase; Intensive Care Units; Neurosurgery

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