Estimation Of Serum Estradiol Levels And Its Co-Relation With Bisap (Bedside Index For Severity In Acute Pancreatitis) Score In Severe Acute Pancreatitis – One Year Hospital Based Cross Sectional Study

Abstract

The present study was undertaken to estimate serum estradiol levels and its co-relation with BISAP ( bedside index for severity in acute pancreatitis) score in severe acute pancreatitis. Methodology This one year cross sectional study was carried out on a total of 45 consecutive patients with SAP admitted in Medical ICU from January 2014 to December 2014 in the Department of Medicine and gastroenterology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. Results Total no. of cases (n) = 45 were included in our study , patients age ranged from 18 to 92 years and mean age was 38.91 years. Out of the 45 cases, 15 patients expired and 30 patients got discharged. Mean age of expired patients was 42.86 years while mean age of discharged patients was 36.93 years. Among the 45 patients, there were 41 (91.1%) males, and 04 (8.9%) females. Out of 41 males, 13 expired and 28 got discharged with respective percentage of 31.7% and 68.3%. Out of 4 females, 2 expired and 2 got discharged with respective percentage of 50% for both. P value (0.459) was not significant for sex distribution. We calculated BISAP score in all our patients. Our study showed a direct correlation between BISAP score and mortality. Out of 15 patients in score 4 category 14 patients expired and one patient improved and got discharged(93.3%). Score 5 category had only one patient with a mortality percentage of 100% ; with significant p value of <0.001. While there was no mortality in score 2 and 3 categories of BISAP score. Our results showed that the serum E2 levels in non survivors were significantly elevated at the time of ICU admission and were 3.1 times higher than those of survivors (mean-148 pg/ml Vs 47.7 pg/ml, p < 0.001). In addition, by applying the ROC curve model, we found that sensitivity of 100%, specificity of 96.7%, positive predictive value of 93.8% , Negative predictive value of 100% and an accuracy of 97.78% could be achieved for the prediction of mortality if a serum E2 level of 79.05 pg/ml was chosen as cut off point. We compared serum E2 levels with BISAP score and found that as the score went on increasing estradiol value was increased, with significant P value <0.001 ; suggestive of reliability of serum E2 levels as an indicator of disease severity. Conclusion and interpretation In our study, There was a positive relationship between increasing estradiol values and the increasing BISAP score in SAP patients. Serum estradiol was found to be a early and better predictor for assessing severity regardless of gender.