Random Blood Glucose Level to Predict Gallstone Pancreatitis Severity in Indonesian Patients

Established gallstone pancreatitis severity predictors are impractical because they require multiple diagnostic variables that take time to develop. This study aimed at finding a simple severity predictor to improve patient management. We conducted this cross-sectional study by extracting data from the medical records of patients with gallstone pancreatitis (ICD 10 code K85.1) in the Cipto Mangunkusumo Hospital during 2008-2016. For statistical analysis, we used random blood glucose (RBG) levels on admission, severity grading based on the 2012 revision of the Atlanta Classification, and mortality. Data included were from 41 patients with gallstone pancreatitis [mean age, 49.2 years; men, 24 (58.5%) and women, 17 (41.5%)]. The median RBG levels in mild, moderately severe, and severe disease groups were 109.5; 131; and 171 mg/dL, respectively. This study found a significant difference in RBG level between patients in the mild and those in the severe disease groups (P = 0.008). ROC curve of RBG and severe gallstone pancreatitis revealed an area under the curve (AUC) of 0.885 (CI 95%, 0.743-1.000). RBG level at 154.5 mg/dL had the optimal sensitivity (75%) and specificity (91.8%) values to predict severe disease. The positive and negative predictive values at the cutoff RBG level of 154.5 mg/dL were 50% and 97.1%, respectively. This study found no association between RBG level and mortality but found an association between severity grading and mortality (P = 0.021; OR 0.028). RBG level can be used to accurately predict gallstone pancreatitis severity.