STUDY OF SERUM PROCALCITONIN AS A PROGNOSTIC MARKER IN ACUTE PANCREATITIS
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Keywords
Procalcitonin, Infected Pancreatic Necrosis, Acute Pancreatitis.
Abstract
Background: One of the main factors influencing the severity of AP (Acute Pancreatitis) in its latter stages is IPN (Infected Pancreatic Necrosis). Finding the best predictors of this severity variable is crucial because IPN is the primary cause of death in AP. Early triage of patients in need of transfer to a referral centre, ICU (Intensive Care Unit) treatment, and/or particular therapies is made possible by an accurate indicator of IPN. We looked at the procalcitonin level as an early indicator of the emergence of problems during the early stages of acute pancreatitis.
Methods: This study was conducted over a period of 18 months involving 130 patients diagnosed with acute pancreatitis. CRP, serum procalcitonin levels and CECT results were analysed.
Results: Patients who had respiratory complications had a serum procalcitonin range from 16.5 to 22.7 ng/dl. Among patients who had renal complications, serum procalcitonin was 15.1 to 18.3 ng/dl. Similarly, patients with severe pancreatitis who developed MODS had a very high range of serum procalcitonin, 16-44.1 and 37.7-112.6 ng/dl, respectively. CRP level did not increase in uncomplicated pancreatitis after two weeks of admission, whereas in MODS and severe pancreatitis it significantly increased. Both CRP and serum procalcitonin levels increased with an increase in the CT severity index.
Conclusion: Our study shows that PCT closely correlates with both infected necrosis and the severity of associated systemic complications. PCT could be a potential independent new indicator for selecting patients with acute pancreatitis at risk of developing infectious necrosis.
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Dr. Ashis Sarkar
Assistant Professor, Department of General Surgery, Barasat Government Medical College & Hospital, Barasat, West Bengal, India.
Dr. Pradip Kumar Mandal
Associate Professor, Department of Anaesthesiology, Malda Medical College & Hospital, Malda, West Bengal, India.
Dr. Debajit Das
Assistant Professor, Department of General Surgery, Malda Medical College & Hospital Malda, West Bengal, India.