Clinical significance of lower admission amylase levels as an indicator of medical management in pancreatic trauma with AAST grade I injury.

Abstract

Purpose: We aimed to explore whether the admission serum amylase levels may help inform the selection of medical management in patients with AAST Grade I pancreatic injuries.

Methods: We retrospectively reviewed the records of 20 patients treated for pancreatic trauma between 2010 and 2024. They were categorized into medical management or intervention groups according to the initial treatment strategy. We used a receiver operating characteristic (ROC) analysis to evaluate the predictive value of the admission serum amylase levels for successful medical management.

Results: Eight patients were treated with strict medical management, whereas 12 required additional interventions. All patients in the medical management group had AAST Grade I injuries, and none required conversion to interventional treatment. The admission serum amylase levels were significantly lower in the medical management group (median 106 vs. 350 IU/L; p = 0.0228), whereas there were no significant intergroup differences in inflammatory markers. The ROC analysis yielded an area under the curve of 0.83 (95% CI, 0.59- 1.00). The cutoff value was 158 IU/L, with a sensitivity of 87.5% and a negative predictive value of 90.9%.

Conclusion: Lower admission serum amylase levels in patients with AAST Grade I pancreatic injury may be associated with suitability for strict medical management; however, these findings are exploratory and require validation in larger multicenter studies.