Serum Calcium Level As A Prognostic Marker In Acute Pancreatitis – One Year Hospital Based Cross-Sectional Study

Abstract

Background and objectives There is no simple biomarker which can serve as the single parameter to determine the severity and prognosis in patients with Acute Pancreatitis. This study was aimed to determine the role of serum calcium level as a prognostic marker in Acute Pancreatitis. Methodology This one year cross sectional study was done from January 2018 to December 2018 in the Department of General Medicine, KLE’s Dr. Prabhakar Kore Hospital and MRC. Based on the Revised Atlanta classification, a total of 100 patients with diagnosis of Acute Pancreatitis were enrolled and serum calcium was determined for comparison with CT Severity Index. Results In this study male preponderance was more (86%) than females and the ratio was 6.14:1. The commonest age group was between 20 to 40 years (64%) and the mean age was 39.21 ± 14.08 years. Ethanol (68%) was the commonest etiology for acute pancreatitis followed by gall bladder calculi (24%). Abdominal pain was the common clinical presentation (80%) and epigastric tenderness as the most common clinical sign (70%). Maximum patients had moderate CTSI score (64%). Serum calcium <8.5 mg/dl was found in 64 patients of which 45 patients had moderate pancreatitis, 14 patients had severe pancreatitis and 5 patients had mild pancreatitis. On comparing the serum calcium level with the CT severity index, we observed that there was decrease in the value of serum calcium in patients who had higher CTSI. A significant inverse co-relation (p=0.0001) was observed between the CTSI and serum calcium levels indicating that hypocalcemia was associated with poor prognosis of Acute Pancreatitis. Conclusion and interpretation Serum calcium level can be used as a simple marker to assess the severity and prognosis of Acute Pancreatitis and helps determine need for intensive care management as it is easily available in primary and secondary care centers.