Evaluation of Procalcitonin as an Early Prognostic Marker in Acute Pancreatitis

Abstract

Komalpreet Kaur1 , Kamal Singh2

BACKGROUND Acute Pancreatitis is usually a mild disease with minimal organ dysfunction. Sometime it can have severe complications and high mortality despite treatment. There is a need to identify patients at risk for complications so as to provide an early effective management. Procalcitonin, an inflammatory biomarker increases in acute pancreatitis with complications. So, we studied procalcitonin serum levels in acute pancreatitis patients to see if it can be used as an early predictor of development of complications. METHODS This was a prospective observational study, carried out at our tertiary care teaching hospital, north INDIA. A total of 60 cases were included in this study as per the inclusion criteria. Serum procalcitonin of ≥0.5 ng/ml was taken as significant. RESULTS Serum procalcitonin (PCT) was found to be non-significant in 61.6% (37 out of 60) patients, out of these, none had any complication, antibiotics use, low CT Severity Index (CTSI) score, early recovery and no death. Serum procalcitonin (PCT) was significant in 38.3% (23 out of 60) patients. CTSI score (>5) in 19 of these patients. Hypotension and respiratory failure were seen in 20 and 21 patients respectively with a significant p value of 0.001. Antibiotic use was observed in all the 23 patients in this group (p value 0.05). Duration of hospital stay was longer (more than mean 7.08±4.018 days) with significant p value of 0.005. Four participants died due to the complications related to acute severe pancreatitis. Mean value of PCT in participants who died was 4.2 ± 3.47 ng/ml with p value of 0.005 CONCLUSIONS Serum procalcitonin level in acute pancreatitis had good correlation with development of complications of cardiovascular, respiratory system, high CT score, and longer duration of hospital stay, antibiotic use and death. Hence procalcitonin can be used to predict complication at an early stage of acute pancreatitis.

image