Failure of the Hong Kong criteria to predict the severity of acute pancreatitis

International Journal of Pancreatology : Official Journal of the International Association of Pancreatology
D I HeathA K Li

Abstract

The results of the present study demonstrate that the HK criteria do not provide effective prediction of severity. Fan et al. (1) have reported previously that a blood urea (BU) > 7.4 mmol/L and/or glucose (BG) > 11 mmol/L at the time of admission to hospital detects a severe attack of acute pancreatitis with a sensitivity of 76% and specificity of 75%. However, a similar study conducted in the West of Scotland did not confirm these findings (sensitivity 33% and specificity 83%). The reason underlying this discrepancy in prediction is unclear, but it may be because of differences in the nature of acute pancreatitis between Asian and Western populations. In this study we examined the predictive ability of the Hong Kong (HK) criteria in a patient population similar to that studied by Fan et al. A consecutive series of 130 patients experienced 135 attacks of acute pancreatitis. One-hundred-and-four (77%) attacks were mild and 31 (23%) severe (including 12 [9.0%] deaths). Eighty-nine (66%) episodes had a biliary etiology. In 19 (14%) of these episodes, the gallstones had a primary ductal origin being associated with recurrent pyogenic cholangitis. Median admission BU concentrations were 5.2 mmol/L (range 3.6-32.1 mmol/L) for the mi...Continue Reading

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Citations

Jan 7, 2009·The British Journal of Surgery·R MofidiR W Parks

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