title: Comparison of serum procalcitonin with Ranson, APACHE-II, Glasgow and Balthazar CT severity index scores in predicting severity of acute pancreatitis.
abstract: OBJECTIVE
  The aim of this study is to assess serum procalcitonin (PCT) for early prediction of severe acute pancreatitis compared with multiple scoring systems and biomarkers.
  
  
  METHODS
  Forty-four patients with acute pancreatitis confirmed by radiological evidences, laboratory assessments, and clinical manifestation were prospectively enrolled. All blood samples and image studies were obtained within 24 hours of admission.
  
  
  RESULTS
  Acute pancreatitis was graded as severe in 19 patients and mild in 25 patients according to the Atlanta criteria. Levels of serum PCT were significantly higher in severe acute pancreatitis (p=0.001). The accuracy of serum PCT as a predicting marker was 77.3%, which was similar to the acute physiology and chronic health examination (APACHE)-II score, worse than the Ranson score (93.2%) and better than the Balthazar CT index (65.9%). The most effective cut-off level of serum PCT was estimated at 1.77 ng/mL (AUC=0.797, 95% CI=0.658-0.935). In comparision to other simple biomarkers, serum PCT had more accurate value (77.3%) than C-reactive protein (68.2%), urea (75.0%) and lactic dehydrogenase (72.7%). Logistic regression analysis revealed that serum PCT has statistical significance in acute severe pancreatitis. Assessment of serum PCT levels and length of hospital stay by simple linear regression analysis revealed effective p-value with low R square level, which could make only possibilty for affection of serum PCT to admission duration (r2=0.127, p=0.021).
  
  
  CONCLUSIONS
  Serum PCT was a promising simple biomarker and had similar accuracy of APACHE-II scores as predicting severity of acute pancreatitis.
authors.affiliation: Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Su Mi
authors.initials: SM
authors.lastname: Woo
authors.forename: Myung Hwan
authors.initials: MH
authors.lastname: Noh
authors.forename: Byung Geun
authors.initials: BG
authors.lastname: Kim
authors.forename: Chien Ter
authors.initials: CT
authors.lastname: Hsing
authors.forename: Ji Sun
authors.initials: JS
authors.lastname: Han
authors.forename: Seung Hee
authors.initials: SH
authors.lastname: Ryu
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Seo
authors.forename: Hyun Ah
authors.initials: HA
authors.lastname: Yoon
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Jang
authors.forename: Seok Reyol
authors.initials: SR
authors.lastname: Choi
authors.forename: Jin Han
authors.initials: JH
authors.lastname: Cho
mesh_terms: D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D011859:Radiography; D012720:Severity of Illness Index; D014508:Urea / Q000097:blood
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D014508:Urea; D002116:Calcitonin; D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase; D015740:Calcitonin Gene-Related Peptide