Malinoski et al studied the significance of elevations in serum lipase and/or amylase following hemorrhagic shock. The authors are from the University of California at Irvine, the University of Arizona and Cedars-Sinai Medical Center in Los Angeles.


Patient selection: trauma with without pancreatic injury


The serum lipase or amylase were considered elevated if they were >= 2 times the upper limit of the normal reference range.


Risk factors for one or more organ failures:

(1) older age (41 +/- 20 years)

(2) massive transfusion (>= 10 units of packed red blood cells within the first 24 hours)

(3) higher injury Severity Score (ISS, 24 +/- 13)

(4) elevated serum amylase

(5) elevated serum lipase

(6) shock (systolic blood pressure < 90 mm Hg in the Emergency Department)


These same risk factors (except for serum lipase elevation) were also associated with an increased risk for mortality.


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