Lipase/amylase ratio

Gumaste, Vivek; Dave, Pradyuman B.; Weissman, Douglas; Messer, Julio

doi:10.1016/0016-5085(91)90089-4

Cited by 81 publications

(3 citation statements)

References 23 publications

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“…(i) This is a retrospective study, which may have selection bias. Because of the retrospective design, we did not investigate other risk factors of severe acute pancreatitis such as lipase [56], prealbumin/fibrinogen [57], and red cell distribution width [58]. (ii) Data were collected in a single tertiary care hospital, which may not be generalized to a local clinic or a community hospital.…”

Section: Discussionmentioning

confidence: 99%

Serum Albumin Is Independently Associated with Persistent Organ Failure in Acute Pancreatitis

Hong

Lin

Zippi

et al. 2017

Canadian Journal of Gastroenterology and Hepatology

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Background and Aims To investigate the association between serum albumin levels within 24 hrs of patient admission and the development of persistent organ failure in acute pancreatitis. Methods A total of 700 patients with acute pancreatitis were enrolled. Multivariate logistic regression and subgroup analysis determined whether decreased albumin was independently associated with persistent organ failure and mortality. The diagnostic performance of serum albumin was evaluated by the area under Receiver Operating Characteristic (ROC) curves. Results As levels of serum albumin decrease, the risk of persistent organ failure significantly increases (Ptrend < 0.001). The incidence of organ failure was 3.5%, 10.6%, and 41.6% in patients with normal albumin and mild and severe hypoalbuminaemia, respectively. Decreased albumin levels were also proportionally associated with prolonged hospital stay (Ptrend < 0.001) and the risk of death (Ptrend < 0.001). Multivariate analysis suggested that biliary etiology, chronic concomitant diseases, hematocrit, blood urea nitrogen, and the serum albumin level were independently associated with persistent organ failure. Blood urea nitrogen and the serum albumin level were also independently associated with mortality. The area under ROC curves of albumin for predicting organ failure and mortality were 0.78 and 0.87, respectively. Conclusion A low serum albumin is independently associated with an increased risk of developing of persistent organ failure and death in acute pancreatitis. It may also be useful for the prediction of the severity of acute pancreatitis.

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Section: Discussionmentioning

confidence: 99%

Serum Albumin Is Independently Associated with Persistent Organ Failure in Acute Pancreatitis

Hong

Lin

Zippi

et al. 2017

Canadian Journal of Gastroenterology and Hepatology

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“…There is conflicting data with respect to the utility of lipase-to-amylase ratio in determining the cause of acute pancreatitis. A prospective study found an increased lipase-to-amylase ratio of greater than two to be indicative of alcoholic pancreatitis, however, many retrospective studies found a ratio greater than five to be predictive of the same [43][44][45]. Another study found the ratio to be suggestive of biliary etiology [46].…”

Section: Amylase Vs Lipase For the Diagnosis Of Acute Pancreatitismentioning

confidence: 99%

Interpretation of serum pancreatic enzymes in pancreatic and nonpancreatic conditions

Bush

Akshintala

2023

Current Opinion in Gastroenterology

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Purpose of review Serum levels of amylase and lipase can be elevated in nonpancreatic conditions that may or may not be associated with abdominal pain. This leads to a large proportion of patients being falsely labeled as having acute pancreatitis. In this review, we aim to summarize the existing evidence on pancreatic enzyme elevation in various pancreatic and nonpancreatic conditions and its practical implications in clinical practice and healthcare. Recent findings Serum amylase and lipase levels are not specific for pancreatitis. Attempts have been made to validate newer biomarkers including pancreatic elastase, serum trypsin, urinary trypsinogen-activated peptide, phospholipase A2, carboxypeptidase B, activated peptide of carboxypeptidase B, the trypsin 2 alpha 1 activation complex, and circulating cell-free DNA for the diagnosis of acute pancreatitis. Summary Serum lipase levels can be elevated in many intra-abdominal inflammatory conditions. Although more sensitive and specific than amylase, serum lipase levels are not sufficient to diagnose acute pancreatitis in patients with abdominal pain. There is a need to increase stress on radiological evidence as well increase cut-off levels of enzyme elevation for a more accurate diagnosis of acute pancreatitis.

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“…Studies have suggested that serum amylase levels on admission to hospital are higher with gallstones [48] but then tend to decline rapidly [49]. Others have shown that a high amylase/lipase ratio is predictive of gallstones [50], though this finding is not consistent. Another study used retrospective multivariate analysis to identify predictive factors differentiating between alcohol and gallstones as the cause of acute pancreatitis [51].…”

Section: Diagnosismentioning

confidence: 99%

Acute Cholangitis and Pancreatitis Secondary to Common Duct Stones: Management Update

1998

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Gallstones are found within the main bile duct (MBD) of 7% to 20% of patients undergoing cholecystectomy. MBD stones are the commonest cause of acute cholangitis and acute pancreatitis. Acute cholangitis is the result of infection superimposed on an obstructed biliary system and carries a high mortality rate if left untreated. The mainstay of treatment is a regimen of broad-spectrum intravenous antibiotics followed by prompt decompression of the obstructed biliary tree. Decompression is best accomplished by the endoscopic route, although transhepatic approaches may also be employed. Gallstone pancreatitis may be associated with cholangitis but is also common as a separate entity. Initial treatment is supportive, although new agents designed to suppress the systemic inflammatory response are under development and have proved beneficial in clinical trials. Severe cases should be treated with systemic antibiotics and early removal of the obstructing stones by endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy. Prophylactic cholecystectomy is recommended to prevent further episodes of gallstone pancreatitis.

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Lipase/amylase ratio

Cited by 81 publications

References 23 publications

Serum Albumin Is Independently Associated with Persistent Organ Failure in Acute Pancreatitis

Serum Albumin Is Independently Associated with Persistent Organ Failure in Acute Pancreatitis

Interpretation of serum pancreatic enzymes in pancreatic and nonpancreatic conditions

Acute Cholangitis and Pancreatitis Secondary to Common Duct Stones: Management Update

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