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Increased admission serum estradiol level is correlated with high mortality in patients with severe acute pancreatitis

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

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.

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Acknowledgments

We sincerely thank An-Tsai Chen, M.D., Ms. Kuang-Ting Chen, MSc., and Yi-Wen Chen, MSc., for their help in statistical analysis and data collection.

Conflict of interest

The authors declare that they have no conflict of interest. They have neither financial nor proprietary interest in the subject matter or materials discussed in the article.

Author information

Authors and Affiliations

  1. Department of Emergency, Nantou Christian Hospital, Nantou, Taiwan, ROC

    Chih-Wei Lu

  2. School of Medicine, China Medical University, 2 Yuh-Der Road, Taichung, 40402, Taiwan, ROC

    Liang-Chih Liu & Chi-Hsun Hsieh

  3. Department of General Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan, ROC

    Liang-Chih Liu

  4. Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan, ROC

    Ya-Ching Hsieh

  5. Department of General Surgery, Nantou Christian Hospital, Nantou, Taiwan, ROC

    Li-Heng Yang

  6. Department of Trauma and Emergency Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan, ROC

    Chih-Wei Lu, Ray-Jade Chen & Chi-Hsun Hsieh

  7. Trauma and Emergency Surgery Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC

    Ray-Jade Chen

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  1. Chih-Wei Lu
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  2. Liang-Chih Liu
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Corresponding author

Correspondence to Chi-Hsun Hsieh.

Additional information

C.-W. Lu and L.-C. Liu contributed equally to this work.

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Lu, CW., Liu, LC., Hsieh, YC. et al. Increased admission serum estradiol level is correlated with high mortality in patients with severe acute pancreatitis. J Gastroenterol 48, 374–381 (2013). https://doi.org/10.1007/s00535-012-0636-6

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  • DOI: https://doi.org/10.1007/s00535-012-0636-6

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