TY - JOUR
T1 - Increased admission serum estradiol level is correlated with high mortality in patients with severe acute pancreatitis
AU - Lu, Chih Wei
AU - Liu, Liang Chih
AU - Hsieh, Ya Ching
AU - Yang, Li Heng
AU - Chen, Ray Jade
AU - Hsieh, Chi Hsun
PY - 2013/3
Y1 - 2013/3
N2 - Background Sexual dimorphism in critical diseases has been documented. Severe acute pancreatitis is a disease with high mortality. We hypothesized that admission sex hormone levels may be used as an early predictor of outcome in these patients. Methods A prospective cohort of patients with severe acute pancreatitis admitted to the intensive care unit for at least 48 h were enrolled (n = 62). Serum levels of estradiol, progesterone, and testosterone were determined on admission. The association of sex hormone levels and various disease severity scoring systems with patient outcome was analyzed. Results There was no difference in overall mortality between the sexes. However, estradiol was significantly elevated in nonsurvivors (39 vs. 206 pg/mL, p <0.001). The estradiol level was the best single-variable predictor of mortality (area under the curve 0.97), followed by the sequential organ failure assessment score, the multiple organ dysfunction score, and the Acute Physiology and Chronic Health Care Evaluation II (APACHE II) score. A serum estradiol level of 102 pg/mL was both sensitive and specific to predict mortality. There were no differences between survivors and non-survivors in terms of age, body mass index, or progesterone and testosterone levels. Conclusions Admission serum estradiol level is a good marker of disease severity and predictor of death in patients with severe acute pancreatitis.
AB - Background Sexual dimorphism in critical diseases has been documented. Severe acute pancreatitis is a disease with high mortality. We hypothesized that admission sex hormone levels may be used as an early predictor of outcome in these patients. Methods A prospective cohort of patients with severe acute pancreatitis admitted to the intensive care unit for at least 48 h were enrolled (n = 62). Serum levels of estradiol, progesterone, and testosterone were determined on admission. The association of sex hormone levels and various disease severity scoring systems with patient outcome was analyzed. Results There was no difference in overall mortality between the sexes. However, estradiol was significantly elevated in nonsurvivors (39 vs. 206 pg/mL, p <0.001). The estradiol level was the best single-variable predictor of mortality (area under the curve 0.97), followed by the sequential organ failure assessment score, the multiple organ dysfunction score, and the Acute Physiology and Chronic Health Care Evaluation II (APACHE II) score. A serum estradiol level of 102 pg/mL was both sensitive and specific to predict mortality. There were no differences between survivors and non-survivors in terms of age, body mass index, or progesterone and testosterone levels. Conclusions Admission serum estradiol level is a good marker of disease severity and predictor of death in patients with severe acute pancreatitis.
KW - Acute pancreatitis
KW - Estradiol
KW - Mortality
UR - http://www.scopus.com/inward/record.url?scp=84884620069&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84884620069&partnerID=8YFLogxK
U2 - 10.1007/s00535-012-0636-6
DO - 10.1007/s00535-012-0636-6
M3 - Article
C2 - 22825551
AN - SCOPUS:84884620069
SN - 0944-1174
VL - 48
SP - 374
EP - 381
JO - Journal of Gastroenterology
JF - Journal of Gastroenterology
IS - 3
ER -