RT Journal Article
SR Electronic
T1 Emergency patients with mild elevations of serum lipase and acute pancreatitis
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 398
OP 405
DO 10.15537/smj.2025.46.4.20240999
VO 46
IS 4
A1 Althunayyan, Saqer M.
A1 Alali, Abdulmajed K.
A1 Alanazi, Laila K.
A1 Alkhalifah, Salma S.
A1 Mashdali, Emad M.
A1 Malabarey, Mohammed A.
A1 AlAsiri, Saad A.
A1 Mobrad, Abdulmajeed M.
YR 2025
UL http://smj.org.sa/content/46/4/398.abstract
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.