The usefulness of laboratory tests in the early assessment of severity of acute pancreatitis

Carlos A. Rettally, Shayne Skarda, Mario A. Garza, Steven Schenker, James H. Grendell

Research output: Contribution to journalReview articlepeer-review

30 Scopus citations


Acute pancreatitis is a disorder that affects approximately 200,000 individuals in the U.S. annually. While most cases are mild, up to 30% of patients will have a complicated course with prolonged hospitalization and significant morbidity and mortality. Early institution of several therapeutic interventions, such as enteral nutrition, prophylactic antibiotics, endoscopic retrograde cholangiopancreatography (ERCP) and intensive care monitoring, have been shown to decrease the morbidity associated with severe acute pancreatitis. However, the ability of clinicians to predict, upon presentation, which patient will have mild or severe pancreatitis has remained poor over the years, thus leading to a delay in the institution of such treatments. Researchers have focused on markers that might improve upon clinical prediction alone. While data have shown the predictive value of tools such as Ranson's and Glasgow's criteria, C-reactive protein (CRP) and the APACHE score, their application in clinical practice has been limited by a time delay of at least 48 h in the former two and by being cumbersome in the latter. Thus, our focus is to critically appraise the evidence available for various biochemical markers in their ability to distinguish mild and severe acute pancreatitis early and more accurately than currently available tools.

Original languageEnglish (US)
Pages (from-to)117-149
Number of pages33
JournalCritical Reviews in Clinical Laboratory Sciences
Issue number2
StatePublished - 2003
Externally publishedYes


  • Cytokine
  • Necrotizing
  • Pancreatitis
  • Phospholipase
  • Polymorphonuclear elastase
  • Trypsinogen
  • Trypsinogen activation peptide

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Clinical Biochemistry
  • Biochemistry, medical


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