Prediction of severe pancreatitis with serum procalcitonin
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Abstract
Background: Acute pancreatitis is a common disease, which defined as an inflammatory process of the pancreas with possible multiple organ involvement inducing multiple organ dysfunction and increased mortality rate. Serum procalcitonin is an enzyme which produced by an inflammatory process. In a recent meta-analysis show sensitivity 98% and specificity 88%.
Objective: Predictive sensitivity of scoring systems, specificity, accuracy and positive and negative predictive values of various markers in prediction of severe pancreatitis.
Sample: Acute pancreatitis patients who were diagnosed at emergency room and out patients department, Department of Medicine, Faculty of Medicine Vajira hospital, Navamindhradhiraj University from April 1, 2017 to February 28, 2018.
Methods: This is prospective diagnostic study. We enrolled 62 cases with acute pancreatitis. Baseline data and risk factors were collected including sex, age, alcohol, smoking, weight, height, body mass index and underlying disease. Serum procalcitonin, C reactive protein, Chest X-rays and biochemical markers of BISAP, Ranson and Modified Marshall scoring system were collected. The data will be analyzed to determine the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of severe pancreatitis compared with final diagnosis of patients.
Results: There were 62 acute pancreatitis patients. 13 patients (20.96%) were diagnosed severe pancreatitis. Area under the curves for serum procalcitonin, BISAP, Modified Marshall scoring system, Ranson and C reactive protein in predicting of severe pancreatitis were 0.85, 0.84, 0.83, 0.73 and 0.58. Sensitivity and specificity values of procalcitonin, BISAP, Modified Marshall scoring system, Ranson, C reactive protein were 92.3% and 73.5%, 69.2% and 98%, 69.2% and 95.9%, 46.2% and 100%, 38.5% and 77.6% respectively.
Conclusion: Serum procalcitonin is simple parameter that can be used for diagnosis of severe pancreatitis. Sensitivity of serum procalcitonin was higher than BISAP, Modified Marshall scoring system, Ranson and CRP.
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References
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