Assessment of the prognostic value of certain acute-phase proteins and procalcitonin in the prognosis of acute pancreatitis.

摘要

OBJECTIVES: Of patients with acute pancreatitis (AP), 20% develop severe attacks that need early and intensive therapy. Yet, to administer such treatment, it is important to classify early on the patients with mild and severe pancreatitis. The aim of this study was to evaluate the role of serum amyloid A, C-reactive protein, procalcitonin, and routinely measured parameters in the early prediction of the course of AP. METHODS: A total of 40 consecutive patients with AP confirmed by computed tomography were prospectively enrolled in the study-29 were graded as mild and 11 were graded as severe. Blood samples were obtained on admission and 24 hours thereafter. RESULTS: Procalcitonin concentration in both measurements was significantly higher in patients with severe pancreatitis, and the cutoff level was estimated at 0.5 ng/mL. Although serum amyloid A and C-reactive protein levels rose significantly during the period of observation, these were not differentiated between both groups. Among the routinely measured parameters, a prognostic value was found for total calcium concentration, lactic dehydrogenase activity, and glucose concentration. CONCLUSIONS: The best efficiency in the early prediction of severe AP would be achieved with the measurement of procalcitonin, total calcium level, and lactic acid dehydrogenase activity immediately after admission to the ward.