PT  - JOURNAL ARTICLE
AU  - Althunayyan, Saqer M.
AU  - Alali, Abdulmajed K.
AU  - Alanazi, Laila K.
AU  - Alkhalifah, Salma S.
AU  - Mashdali, Emad M.
AU  - Malabarey, Mohammed A.
AU  - AlAsiri, Saad A.
AU  - Mobrad, Abdulmajeed M.
TI  - Emergency patients with mild elevations of serum lipase and acute pancreatitis
AID  - 10.15537/smj.2025.46.4.20240999
DP  - 2025 Apr 01
TA  - Saudi Medical Journal
PG  - 398--405
VI  - 46
IP  - 4
4099  - http://smj.org.sa/content/46/4/398.short
4100  - http://smj.org.sa/content/46/4/398.full
SO  - Saudi Med J2025 Apr 01; 46
AB  - Objectives: To estimate the incidence of AP and determine potential predictors and the outcomes. Elevated lipase level of <3 times the upper limit of normal (ULN) cause diagnostic confusion for acute pancreatitis (AP).Methods: A multicenter, 6-year retrospective study enrolled adult patients who were detected with lipase level of 80–240 IU/L in the Emergency Department (ED). The Revised Atlanta Classification was used to identify AP within 72 hour (hr) from the first ED visit.Results: Of 1082 patients, 68 (6.3%) had AP, 393 (36.3%) were hospitalized, 64 (6%) required intensive care unit admission, and 2 (0.2%) died. Most AP cases were confirmed using computed tomography CT; 47 (69.1%), followed by repeated lipase level 15 (22.1%) and ultrasound 14 (20.6%). Alcohol exhibited the highest adjusted odds ratio of predicting AP (3.9–45.6), followed by white blood cell count (1.340–6.222), male gender (1.451–4.308), and higher lipase level (1.009–1.02). Among AP cases, 11.8% required ICU admission and 1 died within 72 hr. Chronic heart disease, obesity, fever, and tachycardia were associated with these critical outcomes.Conclusion: Among the study sample, 6.3% were diagnosed with AP. Most of the cases confirmed by CT and alcohol was the strongest risk factor in predicting AP. A prediction score system to stratify AP risk when lipase is <3 ULN is warranted.