KUMJ | VOL. 15 | NO. 1 | ISSUE 57 | JAN.-MARCH, 2017
To Access the Role of Serum Procalcitonin in Predicting the Severity of Acute Pancreatitis
Kumar S, Jalan A, Patowary BN, Bhandari U
Abstract: Background
Acute Pancreatitis remains a common disorder with devastating consequences
in severe form of disease. In this study we assessed serum procalcitonin for early
prediction of severity of acute pancreatitis and compared it with multiple scoring
systems and biomarkers.
Objective
This is a prospective comparative study in which 125 patients with diagnosis of acute
pancreatitis were enrolled. All blood samples and imaging studies were obtained
within 24-72 hours of admission and the severity was predicted.
Method
This is a prospective comparative study in which 125 patients with diagnosis of acute
pancreatitis were enrolled. All blood samples and imaging studies were obtained
within 24-72 hours of admission and the severity was predicted.
Result
Acute pancreatitis was graded severe in 54 patients and mild in 71 patients as per
the Atlanta criteria. Receiver operating characteristic curve showed the area under
curve of serum procalcitonin was higher (area under curve: 0.887, Confidence
interval: 0.825-0.948) compared to computed tomography severity index scoring
system (Area under curve: 0.841, Confidence interval: 0.771-0.911), Ranson’s score
(Area under curve: 0.796, Confidence interval: 0.715-0.876) and C-reactive protein
(Area under curve: 0.717, Confidence interval: 0.628-0.8.7) in predicting the severity
of acute pancreatitis. The best cut-off value of serum procalcitonin to predict severe
acute pancreatitis was 0.9 ng/ml with 92.6% sensitivity, 80.3% specificity. The
accuracy of serum procalcitonin (85.6%) was better than computed tomography
severity index score (73.6 %), Ranson’s score (76.8%) and C-reactive protein (64.8%).
Conclusion
Multifactorial scoring systems are complex and hard to use in clinical basis. Serum
procalcitonin can be used as a promising single biomarker, easily done in all setup
with better accuracy. And it is comparable to computed tomography severity index
and Ranson’s scores in earlier prediction of severity of acute pancreatitis.
Keyword : Acute pancreatitis, serum procalcitonin, pancreatic necrosis