Aim: To determine the diagnostic accuracy of LDH/AST ratio in the detection of necrosis in acute biliary pancreatitis by taking a CT scan as a gold standard.

Methods: This cross-sectional study was conducted from October 2015 to September 2020. Patients of both sexes and ages ranging from 20 to 70 years with acute biliary pancreatitis were included in the study. Diabetic patients, smokers, and patients who had causes of elevated serum transaminases were excluded from the study. LDH/AST ratio was measured on the 5th post-admission day. A contrast-enhanced CT scan was performed on the 7th post-admission day to validate pancreatic necrosis (PNec). The sensitivity, specificity, and diagnostic accuracy of the LDH/AST ratio were then calculated.

Results: A total of 270 pts with acute biliary pancreatitis were included in the study. The mean age was found to be 34.57±5.527 years. Ninety-three (34.4%) patients were male while 177(65.6%) patients were female. Total 43 (15.92%) patients were predicted to develop pancreatic necrosis on LDH/AST Ratio and among them, 42 (15.55%) were confirmed to have necrosis. The sensitivity of detecting PNec on basis of the LDH/AST ratio was 97.8%, specificity of LDH/AST ratio was 99.5%, positive predictive value was 97% and diagnostic accuracy of LDH/AST ratio was 98.9%.

Conclusion: It was concluded that the LDH/AST Ratio is a strong biochemical marker to detect pancreatic necrosis. Furthermore, age and gender do not have any significant association with pancreatic necrosis.

Keywords: CT Scan, pancreatitis, necrosis