J Neurointensive Care.  2020 Oct;3(2):58-63. 10.32587/jnic.2020.00276.

Analysis of Elevated Serum Amylases, Lipase Levels in Neurointensive Care Unit Based on Abdominal CT Scan

• Park MS
• Yang JS
• Choi HJ
• Jeon JP
• Kang SH
• Cho YJ

• KMID: 2555040
• DOI: http://doi.org/10.32587/jnic.2020.00276

Abstract

Objective
To evaluate the clinical characteristics of patients in neurointensive care unit (NICU) whose pancreatic enzyme has elevated and the appropriate cut off value of amylase, lipase for conducting the computerized tomography (CT) scans.
Methods
This was retrospective study of 66 patients in NICU unit who had elevated pancreatic enzymes from January 2008 to December 2013. We classified the subjects with two groups according to CT findings of pancreas – Balthazar score. Patients’ demographic and clinical data was analyzed and level of amylase, lipase was evaluated using receiver operating characteristics curve.
Results
The patients were categorized into 2 groups according to CT findings. Morphologic alteration of pancreas was classified in Group 1, and normal pancreas in CT findings was classified in Group 2. There were no statistical differences between groups, but peak serum lipase level was elevated in Group 1 with statistical significance (p=0.032). By receiver operating characteristics (ROC) curve, we could suspect pancreatitis more precisely in patients with elevated amylase levels > 2-fold the upper normal limit (207 U/L, 73.3% sensitivity and 60.6% specificity), or elevated lipase levels > 4-fold the upper normal limit (1243 U/L, 80% sensitivity and 60.6% specificity) calculated by maximum of the Youden index.
Conclusions
According to our results, serum lipase level is more significant value for pancreatitis. And abdominal CT should be considered if patient’s amylase levels are more than 2-fold and lipase levels are more than 4-fold.

Keyword

Pancreatitis; Amylases; Lipase; Intensive Care Units; Neurosurgery