Prognosis; Severity; Serum procalcitonin; Acute pancreatitis


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Background: Early accurate severity assessment of patients with acute pancreatitis (AP) is cruicial to decide on the acute management and predict outcomes and prognosis.This is done through multiple scoring systems of which serum procalcitonin (PCT) and BISAP has shown promising results. However,data comparing these methods is still conflicting. Objectives: we aim to assess the role of PCT as a sole indicator and compare it to BISAP in determining severity and prognosis of AP. Methods: Retrospective chart review of all AP cases between June 2012 and February 2017 at Makassed General Hospital, with at least one reading of PCT documented in records. Data regarding patients’ demographics and outcomes were collected. Procalcitonin levels and trends were compared to severity classes and BISAP scores regarding various outcomes of AP. Results: Forty-four patients met our inclusion criteria. Based on the revised Atlanta classification, 26 patients had mild, four moderate and 14 severe AP. Mean serum PCT levels were found to correlate with severity classes (1.28 with mild versus 4.81 with moderate-severe AP; P < 0 .0001). This was even more prominent on follow-up testing after 48hours (1.67 vs 12.89 respectively; P=0.01). This proportional relation was again noted with BISAP scores of 0,1 and 2 where the mean PCT was 0.1,5.0 and 19.1 respectively. A trend of decrease in serial PCT was also noted with mild as compared to a trend of rising PCT in moderate-severe AP. Conclusion: Initial and serial PCT levels directly correlated with disease severity and might offer significant additional prognostic value in AP.



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