Abstract

Dr. Shabbar Hussain Changazi, Dr. Anam Zahra, Dr. Areebah Hassan*, Dr. Usman Ali rehman, Dr. Samiullah Bhatti, Dr. Sumera Siddique, Dr. Zain ul Abideen

ABSTRACT

Introduction: Pancreatitis is inflammatory disease of pancreas which may be acute or chronic. Acute pancreatitis can present with mild, moderate or severe forms. Acute severe pancreatitis may lead to pancreatic necrosis and organ dysfunction. Pancreatic necrosis is the most severe form of inflammation in setting of pancreatitis and results from cellular death of parenchyma of pancreas. Different biochemical markers are being used to predict and detect pancreatic necrosis. Lactate dehydrogenase/Aspartate aminotransferase (LDH/AST) Ratio has been found to be one of the useful markers in detection of pancreatic necrosis. Objective: Objective of this study was to determine the degree of agreement between LDH/AST ratio and CT scan in detection of pancreatic necrosis in acute biliary pancreatitis. Study design: Cross-sectional study Setting: Services Hospital, Lahore. Duration of study: Six months from 18th October 2015 to 17th April 2016. Materials and Methods: A total of 270 patients with pancreatitis between ages 20-75 were included in the study. Data of the patients was collected by a pre-designed Performa. LDH/AST ratio was measured on 7th post admission day. Pancreatic necrosis was labelled on LDH/AST ratio if ratio was greater than 20. CT scan of the patients was done on 7th post admission day to confirm the diagnosis. Data was analyzed using SPSS version 22. Degree of agreement between pancreatic necrosis as suggested by LDH/AST Ratio and that found on CT scan was calculated. Kappa statistics were calculated and chi-square test was applied. Results: Agreement between pancreatic necrosis on LDH/AST Ratio and CT scan was found to be 98.9%. Kappa coefficient was 0.985 which showed strong strength of agreement. Conclusion: LDH/AST Ratio >20 on 7th post- admission day is strongly associated with the development of pancreatic necrosis and can be used as a biochemical marker of pancreatic necrosis.