TY - JOUR
T1 - Endoscopic retrograde cholangiopancreatography discharge tool combined with rapid trypsinogen-2 test to predict same-day discharge
T2 - a prospective cohort study
AU - Sperna Weiland, Christina J.
AU - Engels, Megan M.L.
AU - Scheffer, Robbert C.H.
AU - Van Balkom, Bas
AU - van Hee, Koen
AU - Haarhuis, Bertram J.T.
AU - Drenth, Joost P.H.
AU - van Hooft, Jeanin E.
AU - Siersema, Peter D.
AU - van Geenen, Erwin J.M.
N1 - Publisher Copyright:
Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2025/11
Y1 - 2025/11
N2 - Objectives –Identifying patients at high-risk for endoscopic retrograde cholangiopancreatography (ERCP)-related adverse events (AEs) is important for postendoscopic discharge management. This study assesses two strategies, a urinary trypsinogen-2 (UT-2) dipstick combined with a risk-factor-based ERCP discharge tool, for identifying patients at increased risk of developing AEs. Methods – Between August 2018 and March 2021, 268 patients were enrolled in a multicenter prospective cohort. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the UT-2 dipstick, the discharge tool, and combined strategies were assessed for predicting ERCP-related AEs. Results – Twenty-four (10.5%) AEs occurred in the eligible 228 patients, of which 14 (6.1%) were post-ERCP pancreatitis. The discharge tool and UT-2 dipstick combination outperformed the individual strategies for all AEs with a sensitivity of 66.7% (95% CI, 44.7–84.4%), specificity of 78.5% (95% CI, 72.2–83.9%), PPV of 26.6% (95% CI, 19.8–34.8%) and NPV of 95.3% (95% CI, 91.9–97.3%). For post-ERCP pancreatitis alone, the strategies combined had a sensitivity of 64.3% (95% CI, 35.1–87.2%), specificity of 76.2% (95% CI, 69.9–81.7%), PPV of 14.9% (95% CI, 10.0–21.7%) and NPV of 97.0% (95% CI, 94.2–98.5%). Conclusion – Although the combination of UT-2 dipstick and discharge tool outperforms the two strategies separately in predicting post-ERCP AEs, we would not recommend implementation of either strategy given the low sensitivity when applied separately or combined.
AB - Objectives –Identifying patients at high-risk for endoscopic retrograde cholangiopancreatography (ERCP)-related adverse events (AEs) is important for postendoscopic discharge management. This study assesses two strategies, a urinary trypsinogen-2 (UT-2) dipstick combined with a risk-factor-based ERCP discharge tool, for identifying patients at increased risk of developing AEs. Methods – Between August 2018 and March 2021, 268 patients were enrolled in a multicenter prospective cohort. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the UT-2 dipstick, the discharge tool, and combined strategies were assessed for predicting ERCP-related AEs. Results – Twenty-four (10.5%) AEs occurred in the eligible 228 patients, of which 14 (6.1%) were post-ERCP pancreatitis. The discharge tool and UT-2 dipstick combination outperformed the individual strategies for all AEs with a sensitivity of 66.7% (95% CI, 44.7–84.4%), specificity of 78.5% (95% CI, 72.2–83.9%), PPV of 26.6% (95% CI, 19.8–34.8%) and NPV of 95.3% (95% CI, 91.9–97.3%). For post-ERCP pancreatitis alone, the strategies combined had a sensitivity of 64.3% (95% CI, 35.1–87.2%), specificity of 76.2% (95% CI, 69.9–81.7%), PPV of 14.9% (95% CI, 10.0–21.7%) and NPV of 97.0% (95% CI, 94.2–98.5%). Conclusion – Although the combination of UT-2 dipstick and discharge tool outperforms the two strategies separately in predicting post-ERCP AEs, we would not recommend implementation of either strategy given the low sensitivity when applied separately or combined.
UR - https://www.scopus.com/pages/publications/105008826323
U2 - 10.1097/MEG.0000000000003014
DO - 10.1097/MEG.0000000000003014
M3 - Article
C2 - 40530510
AN - SCOPUS:105008826323
SN - 0954-691X
VL - 37
SP - 1206
EP - 1212
JO - European Journal of Gastroenterology and Hepatology
JF - European Journal of Gastroenterology and Hepatology
IS - 11
ER -