Document Detail


The clinical value of procalcitonin in early assessment of acute pancreatitis.
MedLine Citation:
PMID:  15984987     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Early assessment of the severity and the etiology is crucial in the management of acute pancreatitis. To determine the value of procalcitonin (PCT) as a prognostic marker and as an indicator of biliary etiology in the early phase of acute pancreatitis. METHODS: In a prospective study, 75 consecutive patients were included (severe pancreatitis in 12 patients, biliary etiology in 42 cases). The value of PCT as a prognostic marker was compared to C-reactive protein (CRP), hematocrit (HCT), acute physiology and chronic health evaluation (APACHE) II score, and Ranson score. The value of PCT as an indicator of biliary etiology was compared to alanine aminotransferase (ALT) and alkaline phosphatase (AP). The area under the receiver operating characteristic curve (AUC) was applied as a measure of the overall accuracy of the single markers and multiple scoring systems. RESULTS: The most accurate prediction of severe disease was provided by the APACHE II score on the day of admission (AUC: APACHE II, 0.78; CRP, 0.73; HCT, 0.73; and PCT, 0.61), and by CRP after 48 h (AUC: CRP, 0.94; Ranson score, 0.81; PCT, 0.71; APACHE II score, 0.69; and HCT, 0.46). ALT was the most accurate indicator of biliary pancreatitis (AUC: ALT, 0.83; AP, 0.81; and PCT, 0.68). CONCLUSIONS: PCT is of limited additional value for early assessment of severity and etiology in acute pancreatitis. CRP is found to be a reliable prognostic marker with a delay of 48 h, while ALT is validated as the best indicator of biliary etiology.
Authors:
Ivy Susanne Modrau; Andrea Karen Floyd; Ole Thorlacius-Ussing
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  100     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-06-29     Completed Date:  2005-08-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1593-7     Citation Subset:  IM    
Affiliation:
Department of Gastrointestinal Surgery A, Aalborg Hospital, Aalborg, Denmark.
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MeSH Terms
Descriptor/Qualifier:
APACHE
Acute Disease
Adult
Aged
Aged, 80 and over
Alanine Transaminase / blood
Biliary Tract Diseases / complications
Biological Markers / blood
C-Reactive Protein / analysis
Calcitonin / blood*
Female
Humans
Male
Middle Aged
Pancreatitis / diagnosis*,  etiology
Prognosis
Prospective Studies
Protein Precursors / blood*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Protein Precursors; 56645-65-9/procalcitonin; 9007-12-9/Calcitonin; 9007-41-4/C-Reactive Protein; EC 2.6.1.2/Alanine Transaminase

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