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Multicenter Study
. 2025 Apr;46(4):398-405.
doi: 10.15537/smj.2025.46.4.20240999.

Emergency patients with mild elevations of serum lipase and acute pancreatitis

Saqer M Althunayyan  1 , Abdulmajed K Alali  1 , Laila K Alanazi  1 , Salma S Alkhalifah  1 , Emad M Mashdali  1 , Mohammed A Malabarey  1 , Saad A AlAsiri  1 , Abdulmajeed M Mobrad  1
Affiliations
Multicenter Study

Emergency patients with mild elevations of serum lipase and acute pancreatitis

Saqer M Althunayyan et al. Saudi Med J. 2025 Apr.

Abstract

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.

Keywords: acute pancreatitis; emergency; lipase; mild elevations.

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Figures

Figure 1
Figure 1
- Distribution of the number of patients with confirmed acute pancreatitis according to diagnostic tests. CT: computed tomography, US: ultrasound
See this image and copyright information in PMC

References

    1. Tenner S, Vege SS, Sheth SG, Sauer B, Yang A, Conwell DL, et al. . American college of gastroenterology guidelines: management of acute pancreatitis. Am J Gastroenterol 2024; 119: 419-437. - PubMed
    1. Greenberg JA, Hsu J, Bawazeer M, Marshall J, Friedrich JO, Nathens A, et al. . Clinical practice guideline: management of acute pancreatitis. Can J Surg 2016; 59: 128-140. - PMC - PubMed
    1. Paul J. Recent Advances in diagnosis and severity assessment of acute pancreatitis. Prague Med Rep 2020; 121: 65-86. - PubMed
    1. Mederos MA, Reber HA, Girgis MD.. Acute pancreatitis. JAMA 2021; 325: 382. - PubMed
    1. Seppänen H, Classification Puolakkainen P., severity assessment, and prevention of recurrences in acute pancreatitis. Scandinavian Journal of Surgery 2020; 109: 53-58. - PubMed

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