Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency Department
High-density lipoprotein cholesterol (HDL-C) is reported as a biomarker of systemic inflammation and multi-organ failure (MOF), which has been rarely investigated in acute pancreatitis (AP), a frequent condition in the emergency department (ED). The objective was to study the predictive capacity of...
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MDPI AG
2023-07-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/13/7/1602 |
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| author | Ana Rocío Venegas-Tamayo Olga Mariel Peña-Veites Martha Alicia Hernández-González Cornelio Barrientos-Alvarado |
| author_facet | Ana Rocío Venegas-Tamayo Olga Mariel Peña-Veites Martha Alicia Hernández-González Cornelio Barrientos-Alvarado |
| author_sort | Ana Rocío Venegas-Tamayo |
| collection | DOAJ |
| description | High-density lipoprotein cholesterol (HDL-C) is reported as a biomarker of systemic inflammation and multi-organ failure (MOF), which has been rarely investigated in acute pancreatitis (AP), a frequent condition in the emergency department (ED). The objective was to study the predictive capacity of the decrease in HDL-C to the progression of MOF in AP in the ED; analyzing 114 patients with AP for one year in a longitudinal and prospective study, AP severity was obtained by the Atlanta classification, in relation to modified Marshall and Bedside Index for Severity in Acute Pancreatitis (BISAP) scores, and clinical and laboratory parameters in a 48 h hospital stay. The area under the receiver operating characteristic (ROC) curve was used to estimate the validity of the predictor and define optimal cut-off points. It was found that AP was classified as severe in 24.5%, mainly for biliary etiology (78.9%) and female sex (73.6%). As a biomarker, HDL-C decreased from 31.6 to 29.5 mg/dL in a 48 h stay (<i>p</i> < 0.001), correlating negatively with the increase in severity index > 2 and the modified Marshall (<i>p</i> < 0.032) and BISAP (<i>p</i> < 0.009) scores, finding an area under the ROC curve with a predictive capacity of 0.756 (95% CI, 0.614–0.898; <i>p</i> < 0.004) and a cut-off point of 28.5 mg/dL (sensitivity: 79%, specificity: 78%), demonstrating that the decrease in HDL-C levels serves as a useful indicator with a predictive capacity for MOF in mild to severe AP, during a 48 h hospital stay in the ED. |
| first_indexed | 2024-03-11T00:53:35Z |
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| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-11T00:53:35Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-2c249f99b0ae4aa685b5c8087fb096bf2023-11-18T20:10:51ZengMDPI AGLife2075-17292023-07-01137160210.3390/life13071602Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency DepartmentAna Rocío Venegas-Tamayo0Olga Mariel Peña-Veites1Martha Alicia Hernández-González2Cornelio Barrientos-Alvarado3High Specialty Medical Unit No. 1, National Medical Center of Bajío, Mexican Social Security Institute, Leon 37320, Guanajuato, MexicoHigh Specialty Medical Unit No. 1, National Medical Center of Bajío, Mexican Social Security Institute, Leon 37320, Guanajuato, MexicoHigh Specialty Medical Unit No. 1, National Medical Center of Bajío, Mexican Social Security Institute, Leon 37320, Guanajuato, MexicoDepartment of Physiology, Higher School of Medicine, National Polytechnic Institute, Mexico City 11340, MexicoHigh-density lipoprotein cholesterol (HDL-C) is reported as a biomarker of systemic inflammation and multi-organ failure (MOF), which has been rarely investigated in acute pancreatitis (AP), a frequent condition in the emergency department (ED). The objective was to study the predictive capacity of the decrease in HDL-C to the progression of MOF in AP in the ED; analyzing 114 patients with AP for one year in a longitudinal and prospective study, AP severity was obtained by the Atlanta classification, in relation to modified Marshall and Bedside Index for Severity in Acute Pancreatitis (BISAP) scores, and clinical and laboratory parameters in a 48 h hospital stay. The area under the receiver operating characteristic (ROC) curve was used to estimate the validity of the predictor and define optimal cut-off points. It was found that AP was classified as severe in 24.5%, mainly for biliary etiology (78.9%) and female sex (73.6%). As a biomarker, HDL-C decreased from 31.6 to 29.5 mg/dL in a 48 h stay (<i>p</i> < 0.001), correlating negatively with the increase in severity index > 2 and the modified Marshall (<i>p</i> < 0.032) and BISAP (<i>p</i> < 0.009) scores, finding an area under the ROC curve with a predictive capacity of 0.756 (95% CI, 0.614–0.898; <i>p</i> < 0.004) and a cut-off point of 28.5 mg/dL (sensitivity: 79%, specificity: 78%), demonstrating that the decrease in HDL-C levels serves as a useful indicator with a predictive capacity for MOF in mild to severe AP, during a 48 h hospital stay in the ED.https://www.mdpi.com/2075-1729/13/7/1602high-density lipoprotein cholesterolacute pancreatitismultiple organ failureAtlanta classificationBedside Index for Severity of Acute Pancreatitismodified Marshall score |
| spellingShingle | Ana Rocío Venegas-Tamayo Olga Mariel Peña-Veites Martha Alicia Hernández-González Cornelio Barrientos-Alvarado Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency Department Life high-density lipoprotein cholesterol acute pancreatitis multiple organ failure Atlanta classification Bedside Index for Severity of Acute Pancreatitis modified Marshall score |
| title | Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency Department |
| title_full | Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency Department |
| title_fullStr | Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency Department |
| title_full_unstemmed | Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency Department |
| title_short | Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency Department |
| title_sort | decreased hdl c levels as a predictor of organ failure in acute pancreatitis in the emergency department |
| topic | high-density lipoprotein cholesterol acute pancreatitis multiple organ failure Atlanta classification Bedside Index for Severity of Acute Pancreatitis modified Marshall score |
| url | https://www.mdpi.com/2075-1729/13/7/1602 |
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