Correlation between procalcitonin and intra-abdominal pressure and their role in prediction of the severity of acute pancreatitis |
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| Authors: | Mihailo Bezmarevic Darko Mirkovic Ivan Soldatovic Dusica Stamenkovic Nikola Mitrovic Nenad Perisic Ivan Marjanovic Sasa Mickovic Menelaos Karanikolas |
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| Institution: | 1. Clinic for General Surgery, Military Medical Academy, Crnotravska 17, 11 000 Belgrade, Serbia;2. Institute of Statistic and Informatic, Faculty of Medicine, University of Belgrade, Belgrade, Serbia;3. Department of Anasthesiology and Intensive care, Military Medical Academy, Belgrade, Serbia;4. Clinic for Infectious and Tropical Diseases, Faculty of Medicine, University of Belgrade, Belgrade, Serbia;5. Clinic for Gastroenterology, Military Medical Academy, Belgrade, Serbia;6. Clinic for Vascular and Endovascular Surgery, Military Medical Academy, Belgrade, Serbia;7. Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA;1. Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA;2. Indiana University School of Medicine, Indianapolis, IN, USA;1. Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012, India;2. Department of Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012, India;1. Center for Pancreatic and Liver Disease, St. Luke’s Health System, 100 E. Idaho St., Suite 301, Boise, ID 83712;2. Department of Interventional Radiology, St. Luke’s Health System, 100 E. Idaho St., Suite 301, Boise, ID 83712;3. Department of Diagnostic Radiology, St. Luke’s Health System, , 100 E. Idaho St., Suite 301, Boise, ID 83712;1. Department of Gastroenterology, PGIMER, Chandigarh, India;2. Department of Gastroenterology, AIIMS, Rishikesh, India;3. Department of Virology, PGIMER, Chandigarh, India;1. Gastroenterology and Nutrition Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY;2. Hepatopancreatobiliary Surgery Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY |
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| Abstract: | Background/aimsEarly assessment of disease severity and vigilant patient monitoring are key factors for adequate treatment of acute pancreatitis (AP). The aim of this study was to determine the correlation of procalcitonin (PCT) serum concentrations and intra-abdominal pressure (IAP) as prognostic markers in early stages of AP.MethodsThis prospective observational study included 51 patients, of which 29 had severe AP (SAP). Patients were evaluated with the Acute Physiology And Chronic Health Evaluation (APACHE II) score, C-reactive protein (CRP) and PCT serum concentrations and IAP at 24 h from admission. PCT was measured three times in the 1st week of disease and three times afterward, while IAP was measured daily. PCT and IAP values correlated with each other, and also compared with APACHE II score and CRP values.ResultsPCT, IAP, CRP values and APACHE II score at 24 h after hospital admission were significantly elevated in patients with SAP. There was significant correlation between PCT and IAP values measured at 24 h of admission, and between maximal PCT and IAP values. Sensitivity/specificity for predicting AP severity at 24 h after admission was 89%/69% for APACHE II score, 75%/86% for CRP, 86%/63% for PCT and 75%/77% for IAP.ConclusionsIncreased IAP was accompanied by increased PCT serum concentration in patients with AP. PCT and IAP can both be used as early markers of AP severity. |
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