Utility of serum phosphate as a marker for predicting the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis

Young Hoon Choi, Dong Kee Jang, Sang Hyub Lee, Sunguk Jang, Jin Ho Choi, Jinwoo Kang, Woo Hyun Paik, Jun Kyu Lee, Ji Kon Ryu, Yong Tae Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: To date, no reliable marker for predicting the severity of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis exists. A previous animal study reported a correlation between serum phosphate level and the severity of acute pancreatitis. Objective: The purpose of this study was to evaluate the feasibility of serum phosphate as a marker for predicting the severity of post-ERCP pancreatitis in humans. Methods: A cohort of patients that were diagnosed with post-ERCP pancreatitis between January 2005 and December 2016 was queried. In addition to serum phosphate levels measured between 12 and 24 hours after ERCP, several candidates deemed suitable for accurately predicting the severity of post-ERCP pancreatitis were also explored. Results: A total of 191 patients with severe (n = 42, 22.0%) and mild-to-moderate (n = 149, 78.0%) post-ERCP pancreatitis were included. Several factors for predicting severe post-ERCP pancreatitis were identified in the multivariate analysis: malignancy as the primary indication for ERCP (odds ratio (OR) 2.65, P = 0.038), systemic inflammatory response syndrome (OR 4.49, P = 0.016) and serum phosphate level (OR 1.97, P = 0.040). In the receiver operating characteristic analysis, the area under the curve of serum phosphate level for severe post-ERCP pancreatitis was 0.65 (95% confidence interval, 0.56–0.75). The optimal cut-off value of serum phosphate level for prediction of severe post-ERCP pancreatitis was 3.35 mg/dL (sensitivity, 0.62; specificity, 0.73). Conclusions: Serum phosphate level after ERCP can be used as a reliable prognostic marker in predicting the severity of post-ERCP pancreatitis. Future prospective studies would be the cogent next step in validating its value.

Original languageEnglish
Pages (from-to)895-901
Number of pages7
JournalUnited European Gastroenterology Journal
Volume6
Issue number6
DOIs
StatePublished - 1 Jul 2018

Fingerprint

Endoscopic Retrograde Cholangiopancreatography
Pancreatitis
Phosphates
Serum
Odds Ratio
Systemic Inflammatory Response Syndrome
ROC Curve
Area Under Curve
Multivariate Analysis
Prospective Studies
Confidence Intervals

Keywords

  • Endoscopic retrograde cholangiopancreatography
  • biomarker
  • pancreatitis
  • phosphate
  • prognosis

Cite this

@article{ae20937189594a8a9ecc7897ca5736d9,
title = "Utility of serum phosphate as a marker for predicting the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis",
abstract = "Background: To date, no reliable marker for predicting the severity of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis exists. A previous animal study reported a correlation between serum phosphate level and the severity of acute pancreatitis. Objective: The purpose of this study was to evaluate the feasibility of serum phosphate as a marker for predicting the severity of post-ERCP pancreatitis in humans. Methods: A cohort of patients that were diagnosed with post-ERCP pancreatitis between January 2005 and December 2016 was queried. In addition to serum phosphate levels measured between 12 and 24 hours after ERCP, several candidates deemed suitable for accurately predicting the severity of post-ERCP pancreatitis were also explored. Results: A total of 191 patients with severe (n = 42, 22.0{\%}) and mild-to-moderate (n = 149, 78.0{\%}) post-ERCP pancreatitis were included. Several factors for predicting severe post-ERCP pancreatitis were identified in the multivariate analysis: malignancy as the primary indication for ERCP (odds ratio (OR) 2.65, P = 0.038), systemic inflammatory response syndrome (OR 4.49, P = 0.016) and serum phosphate level (OR 1.97, P = 0.040). In the receiver operating characteristic analysis, the area under the curve of serum phosphate level for severe post-ERCP pancreatitis was 0.65 (95{\%} confidence interval, 0.56–0.75). The optimal cut-off value of serum phosphate level for prediction of severe post-ERCP pancreatitis was 3.35 mg/dL (sensitivity, 0.62; specificity, 0.73). Conclusions: Serum phosphate level after ERCP can be used as a reliable prognostic marker in predicting the severity of post-ERCP pancreatitis. Future prospective studies would be the cogent next step in validating its value.",
keywords = "Endoscopic retrograde cholangiopancreatography, biomarker, pancreatitis, phosphate, prognosis",
author = "Choi, {Young Hoon} and Jang, {Dong Kee} and Lee, {Sang Hyub} and Sunguk Jang and Choi, {Jin Ho} and Jinwoo Kang and Paik, {Woo Hyun} and Lee, {Jun Kyu} and Ryu, {Ji Kon} and Kim, {Yong Tae}",
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Utility of serum phosphate as a marker for predicting the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis. / Choi, Young Hoon; Jang, Dong Kee; Lee, Sang Hyub; Jang, Sunguk; Choi, Jin Ho; Kang, Jinwoo; Paik, Woo Hyun; Lee, Jun Kyu; Ryu, Ji Kon; Kim, Yong Tae.

In: United European Gastroenterology Journal, Vol. 6, No. 6, 01.07.2018, p. 895-901.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Utility of serum phosphate as a marker for predicting the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis

AU - Choi, Young Hoon

AU - Jang, Dong Kee

AU - Lee, Sang Hyub

AU - Jang, Sunguk

AU - Choi, Jin Ho

AU - Kang, Jinwoo

AU - Paik, Woo Hyun

AU - Lee, Jun Kyu

AU - Ryu, Ji Kon

AU - Kim, Yong Tae

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Background: To date, no reliable marker for predicting the severity of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis exists. A previous animal study reported a correlation between serum phosphate level and the severity of acute pancreatitis. Objective: The purpose of this study was to evaluate the feasibility of serum phosphate as a marker for predicting the severity of post-ERCP pancreatitis in humans. Methods: A cohort of patients that were diagnosed with post-ERCP pancreatitis between January 2005 and December 2016 was queried. In addition to serum phosphate levels measured between 12 and 24 hours after ERCP, several candidates deemed suitable for accurately predicting the severity of post-ERCP pancreatitis were also explored. Results: A total of 191 patients with severe (n = 42, 22.0%) and mild-to-moderate (n = 149, 78.0%) post-ERCP pancreatitis were included. Several factors for predicting severe post-ERCP pancreatitis were identified in the multivariate analysis: malignancy as the primary indication for ERCP (odds ratio (OR) 2.65, P = 0.038), systemic inflammatory response syndrome (OR 4.49, P = 0.016) and serum phosphate level (OR 1.97, P = 0.040). In the receiver operating characteristic analysis, the area under the curve of serum phosphate level for severe post-ERCP pancreatitis was 0.65 (95% confidence interval, 0.56–0.75). The optimal cut-off value of serum phosphate level for prediction of severe post-ERCP pancreatitis was 3.35 mg/dL (sensitivity, 0.62; specificity, 0.73). Conclusions: Serum phosphate level after ERCP can be used as a reliable prognostic marker in predicting the severity of post-ERCP pancreatitis. Future prospective studies would be the cogent next step in validating its value.

AB - Background: To date, no reliable marker for predicting the severity of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis exists. A previous animal study reported a correlation between serum phosphate level and the severity of acute pancreatitis. Objective: The purpose of this study was to evaluate the feasibility of serum phosphate as a marker for predicting the severity of post-ERCP pancreatitis in humans. Methods: A cohort of patients that were diagnosed with post-ERCP pancreatitis between January 2005 and December 2016 was queried. In addition to serum phosphate levels measured between 12 and 24 hours after ERCP, several candidates deemed suitable for accurately predicting the severity of post-ERCP pancreatitis were also explored. Results: A total of 191 patients with severe (n = 42, 22.0%) and mild-to-moderate (n = 149, 78.0%) post-ERCP pancreatitis were included. Several factors for predicting severe post-ERCP pancreatitis were identified in the multivariate analysis: malignancy as the primary indication for ERCP (odds ratio (OR) 2.65, P = 0.038), systemic inflammatory response syndrome (OR 4.49, P = 0.016) and serum phosphate level (OR 1.97, P = 0.040). In the receiver operating characteristic analysis, the area under the curve of serum phosphate level for severe post-ERCP pancreatitis was 0.65 (95% confidence interval, 0.56–0.75). The optimal cut-off value of serum phosphate level for prediction of severe post-ERCP pancreatitis was 3.35 mg/dL (sensitivity, 0.62; specificity, 0.73). Conclusions: Serum phosphate level after ERCP can be used as a reliable prognostic marker in predicting the severity of post-ERCP pancreatitis. Future prospective studies would be the cogent next step in validating its value.

KW - Endoscopic retrograde cholangiopancreatography

KW - biomarker

KW - pancreatitis

KW - phosphate

KW - prognosis

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