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Analysis of CT Grading and Pancreatic Enzymes of Blunt Pancreatic Injury
摘要
PURPOSE. The aims of this study are to evaluate the association of pancreatic enzymes and computed tomography (CT) injury grading with blunt pancreatic injury, and to predict the choice of management. MATERIALS AND METHODS. From January 2010 to December 2017, 48 patients who presented to the emergency department with history of blunt pancreatic trauma were retrieved. Seven patients were excluded by exclusion criteria. The demographics, pancreatic enzymes, CT examination, choice of management, pancreas-related complications and length of stay of 41 patients were retrospectively investigated. Univariate and multivariate analyses as well as receiver operating characteristic curves were used for analyses of the association with grades of injury and prediction of management. RESULTS. The association of major injuries with initial serum amylase ≥ 254 U/L (p = 0.026) and initial serum lipase ≥ 159 U/ L (p = 0.019) was statistically significant. Intervention management was highly associated with major pancreatic injury (p ＜ 0.001) and was significantly associated with elevated initial serum amylase ≥ 260 U/L (p ＜ 0.001) and lipase ≥ 185 U/L (p = 0.005) levels or peak serum amylase ≥ 390 U/L (p ＜ 0.001) and lipase ≥ 700 U/L (p ＜ 0.001) levels. Multivariate logistic regression analysis confirmed that only peak serum amylase level (odds ratio = 1.006; 95% confidence interval [CI] = 1.001-1.011; p = 0.029) and modified CT grades (odds ratio = 501.000; 95% CI = 3.000-95655.000; p = 0.020) were significant predictors of intervention management for blunt pancreatic injury. CONCLUSION. Major pancreatic injury is associated with elevation of initial serum amylase and lipase levels. Major pancreatic injury and peak serum amylase are predictors of intervention management.
延伸閱讀
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