Early diagnosis and prediction of severity in acute pancreatitis using the urine trypsinogen-2 dipstick test: A prospective study

Table 1 Diagnosis and/or etiology of pancreatitis in the control and study groups

Control group	n (%)	Study group	n (%)
Familial Mediterranean fever	5 (20)	Gallstone	58 (63.0)
Acute appendicitis	5 (20)	Idiopatic	18 (19.6)
Acute cholecystitis	4 (16)	Post-ERCP	8 (8.7)
Perforated peptic ulcer	3 (12)	Alcohol	5 (5.4)
Acute cholangitis	2 (8)	Hypertriglyceridemia	3 (3.3)
Pelvic inflammatory disease	2 (8)
Intestinal obstruction	2 (8)
Gastric cancer	1 (4)
Meckel diverticulitis	1 (4)

ERCP: Endoscopic retrograde cholangiopancreaticography.

Table 2 Demographics and results for control and study groups

	Control group(n = 25)	Study group(n = 92)	P
Age (yr)1	59.2 ± 13.5 (34-78)	58.9 ± 14.2 (36-80)	0.928
Gender (F/M)	15/10	69/23	0.113
BMI (kg/m2)1	23.5 ± 3.4 (16-30)	24.0 ± 3.8 (16-33)	0.902
Amylase (> 100 U/L)1	67 ± 32.5 (18-176)	600.8 ± 189.7 (376-1250)	0.000
Lipase (> 60 U/L)1	33.8 ± 15 (13-65)	96.2 ± 42.4 (58-230)	0.000
UTDT +/- (on admission)	2/23	87/5	0.000
UTDT +/- (48 h later)	1/23	87/5	0.000
Duration of UTDT positivity (d)1	2.0 ± 1.4 (1-3)	3.6 ± 2.1 (2-13)	0.000
APACHE II score (on admission)1	4.6 ± 1.5 (3-8)	6.1 ± 2.7 (3-13)	0.006

¹Values expressed in mean ± SE (inter-quartile range).

Table 3 Demographics and results for control and study groups (Classified as mild and severe AP)

	Control	Mild AP	Severe AP	P1	P2	P3
	(n = 25)	(n = 66)	(n = 26)
Age (yr)4	59.2 ± 13.5	58.7 ± 14.3	60.2 ± 14.9	0.883	0.796	0.655
Gender (F/M)	15/10	51/15	17/9	0.118	0.776	0.365
BMI (kg/m2)4	23.5 ± 3.4	23.5 ± 3.9	24.2 ± 4.1	0.627	0.507	0.217
Amylase (> 100 U/L)4	67 ± 32.5	578.6 ± 171	658.2 ± 222	0.000	0.000	0.068
Lipase (> 60 U/L)4	33.8 ± 1	76.0 ± 23.9	110.4 ± 54.2	0.000	0.000	0.000
Positive UTDT	2/23	61/5	26/0	0.000	0.000	0.351
(on admission)
Positive UTDT	1/24	61/5	26/0	0.000	0.003	0.351
(48 h later)
Duration of UTDT positivity (d)4	2.0 ± 1.4	2.6 ± 0.6	6.2 ± 2.5	0.000	0.000	0.000
APACHE-II score	4.6 ± 1.5	4.7 ± 1.4	9.7 ± 1.8	0.807	0.000	0.000
(on admission)4
APACHE-II score	-	4.24 ± 1.4	11.5 ± 2.9	-	-	0.000
(after 48 h)4
Ranson score	-	1.03 ± 0.8	3.73 ± 1	-	-	0.000
(on admission) > 24

¹Control group vs mild AP;

²Control group vs severe AP; ³Mild AP vs severe AP;

⁴Values expressed as means ± SD.

Table 4 Sensitivity, specificity, PPV, NPV, PLR and NLR of serum amylase, serum lipase, UTDT and APACHE II scoring systems in AP

	Sensitivity	Specificity	PPV	NPV	PLR	NLR
	%	%	%	%
On admission
Serum amylase (> 100 U/L)	78.0	87.3	94.8	61.5	6.1	0.3
Serum lipase (> 60 U/L)	86.2	89.4	96.6	76.0	8.1	0.2
UTDT, positive	91.0	72.0	96.6	70.4	3.4	0.1
APACHE II > 8	56.0	89.4	61.0	84.2	5.3	0.5

Table 5 Comparisons of sensitivity and specificity of UTDT in AP in present study with those reported previously

Reference	Sensitivity (%)	Specificity (%)
Kemppainen et al 1997[29]	94	95
Kylanpaa-Back et al 2000[28]	96	92
Lempinen et al 2001[5]	62	87
Pezzilli et al 2001[27]	53.3	-
Lempinen et al 2003[7]	72	81
Chen et al 2005[16]	89.6	85.7
Saes et al 2005[30]	68	86.4
Present study	91	72