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Most patients with acute pancreatitis (AP) develop mild disease, but up to 20% develop severe disease. Many clinicians monitor serum levels of amylase and lipase in an attempt to predict the disease course, but this strategy has not been recommended by practice guidelines. We performed a retrospective analysis to determine whether the percentage changes in amylase and lipase were associated with the severity of disease that developed in patients with AP.

We analyzed data collected from 182 consecutive patients with AP (21 with severe AP) admitted to the Cleveland Clinic from January 2008 through May 2010 (discover cohort). The association between 11 different factors and the severity of AP were assessed by univariable analysis; multivariable models were explored through stepwise selection regression. The percentage change in the serum level of amylase was calculated …