Coffey et al reported predictors for severe pancreatitis in a pediatric patient. These can help to identify a patient who may require more aggressive management and a longer hospital stay. The authors are from the University of New South Wales, John Hunter Children's Hospital and Sydney Children's Hospital Randwick in Australia.
Patient selection: pediatric with acute pancreatitis
Predictors from within 24 hours of admission using multivariate analysis:
(1) serum lipase >= 7 times upper limit of normal (ULN, OR 7.3)
(2) hemoglobin in g/L >= 143 (OR 2.8)
where:
• A cutoff for hemoglobin > 138 g/L might be a more inclusive measured. The range for non-severe was 113 to 138. The range for severe was 127 to 148.
Additional factors from univariate analysis:
(1) serum amylase >= 3 times ULN (covariate with lipase)
(2) serum phosphate <= 1.35 mmol/L
Performance:
• The area under the ROC curve for serum lipase alone was 0.8.
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