Evaluation of serum procalcitonin levels and changes in hematocrit in prediction of severity of acute pancreatitis

Abstract

Background: Mortality in severe acute pancreatitis (AP) is 15-30 % while it is only 0-1 % in case of mild AP. Predicting severity of pancreatitis early in the course of disease is critical to maximize therapy and to prevent and minimize organ dysfunction and complications. This study is aimed to explore if serum procalcitonin level and hematocrit values could be used for prognosticating the severity of AP.

Method: The study was a prospective observational study conducted in a tertiary care hospital of North India on 53 consecutive patients admitted with acute pancreatitis. Serum procalcitonin was estimated on Day 1, 3 and 5 and hematocrit levels were noted at the time 0,24,48,72,96 hours and correlated with the severity of acute pancreatitis and outcomes like local and systemic complications and length of hospital stay.

Results: Procalcitonin had sensitivity of 92.9 % and specificity of 100% while hematocrit had 100% sensitivity and specificity of 91.9% for prediction of severity of acute pancreatitis. Procalcitonin value cut-off >0.75 ng/ml had a diagnostic accuracy of 98.10% and hematocrit level cut off of >45.6% had a diagnostic accuracy of 94.10% for correctly predicting the severity of acute pancreatitis.

Conclusion: Procalcitonin and hematocrit values at the time of admission are two simple and convenient biomarkers that can be used to predict severity of acute pancreatitis because of their easy availability, low cost and good diagnostic accuracy as compared with other laboratory parameters and complicated scoring systems.