title: Tissue factor in predicted severe acute pancreatitis.
abstract: OBJECTIVE
  to study tissue factor (TF) in acute pancreatitis and evaluate the role of TF as a predictive marker of severity.
  
  
  METHODS
  forty-nine consecutive patients admitted to Lund University Hospital, fulfilling the criteria of predicted severe acute pancreatitis (AP), were recruited prospectively between 2002 and 2004. Blood samples for TF analyses were drawn at inclusion in the study and 12 h, 1 d and 3 d later.
  
  
  RESULTS
  twenty-seven patients developed mild AP, and 22 patients severe AP. At inclusion in the study, the groups were comparable with respect to gender, aetiology, Acute Physiology and Chronic Health Evaluation II score, and duration of pain. At inclusion in the study and at 12 h, TF was higher in the severe AP group (P = 0.035 and P = 0.049, respectively). After 1 and 3 d, no differences in TF levels were noted. Interleukin (IL)-6 was significantly higher in the severe AP group at all of the studied time points. C-reactive protein (CRP) was significantly higher in the AP group at 1 and 3 d. In receiver operating characteristic-curves, the area under the curve (AUC) for TF was 0.679 (P = 0.035) at inclusion in the study, and a cut off level for TF of 40 pg/mL showed a sensitivity of 71% and a specificity of 67%, whereas corresponding AUC for IL-6 was 0.775, P = 0.001, and for CRP was 0.653. IL-6 showed better AUC-values than TF at all time points studied.
  
  
  CONCLUSIONS
  TF-levels are raised early in severe AP. TF as an early predictive marker of severe AP is superior to CRP, but inferior to IL-6.
authors.affiliation: Department of Surgery, Clinical Sciences Lund, Lund University and Lund University Hospital, SE-221 85 Lund, Sweden. ellen.andersson@med.lu.se
authors.forename: Ellen
authors.initials: E
authors.lastname: Andersson
authors.forename: Jakob
authors.initials: J
authors.lastname: Axelsson
authors.forename: Gunilla
authors.initials: G
authors.lastname: Eckerwall
authors.forename: Daniel
authors.initials: D
authors.lastname: Ansari
authors.forename: Roland
authors.initials: R
authors.lastname: Andersson
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood*; D012372:ROC Curve; D013925:Thromboplastin / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D013925:Thromboplastin