SIRS score on admission and initial concentration of IL-6 as severe acute pancreatitis outcome predictors.
OBJECTIVE
Early recognition of severe form of acute pancreatitis is important because these patients need more agressive diagnostic and therapeutical approach an can develope systemic complications such as: sepsis, coagulopathy, Acute Lung Injury (ALI), Acute Respiratory Distress Syndrome (ARDS), Multiple Organ Dysfunction Syndrome (MODS), Multiple Organ Failure (MOF). To determine role of the combination of Systemic Inflammatory Response Syndrome (SIRS) score and serum Interleukin-6 (IL-6) level on admission as predictor of illness severity and outcome of Severe Acute Pancreatitis (SAP).


METHODS
We evaluated 234 patients with first onset of SAP appears in last twenty four hours. A total of 77 (33%) patients died. SIRS score and serum IL-6 concentration were measured in first hour after admission.


RESULTS
In 105 patients with SIRS score 3 and higher, initial measured IL-6 levels were significantly higher than in the group of remaining 129 patients (72 +/- 67 pg/mL, vs 18 +/- 15 pg/mL). All nonsurvivals were in the first group, with SIRS score 3 and 4 and initial IL-6 concentration 113 +/- 27 pg/mL. The values of C-reactive Protein (CRP) measured after 48h, Acute Physiology and Chronic Health Evaluation (APACHE II) score on admission and Ranson score showed the similar correlation, but serum amylase level did not correlate significantly with Ranson score, IL-6 concentration and APACHE II score.


CONCLUSIONS
The combination of SIRS score on admission and IL-6 serum concentration can be early, predictor of illness severity and outcome in SAP.
Gregoric
Pavle
P
Center of Emergency Surgery, Clinical Center of Serbia and School of Medicine, University of Belgrade, Belgrade, Serbia.
Pavle
Gregoric
G
Sijacki
Ana
A
Ana
Sijacki
S
Stankovic
Sanja
S
Sanja
Stankovic
S
Radenkovic
Dejan
D
Dejan
Radenkovic
R
Ivancevic
Nenad
N
Nenad
Ivancevic
I
Karamarkovic
Aleksandar
A
Aleksandar
Karamarkovic
K
Popovic
Nada
N
Nada
Popovic
P
Karadzic
Borivoje
B
Borivoje
Karadzic
K
Stijak
Lazar
L
Stefanovic
Branislav
B
Branislav
Stefanovic
S
Milosevic
Zoran
Z
Zoran
Milosević
M
Bajec
Djordje
D
Djordje
Bajec
B
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood*
D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein