Correlation between procalcitonin and intra-abdominal pressure and their role in prediction of the severity of acute pancreatitis.
OBJECTIVE
Early assessment of disease severity and vigilant patient monitoring are key factors for adequate treatment of acute pancreatitis (AP). The aim of this study was to determine the correlation of procalcitonin (PCT) serum concentrations and intra-abdominal pressure (IAP) as prognostic markers in early stages of AP.


METHODS
This prospective observational study included 51 patients, of which 29 had severe AP (SAP). Patients were evaluated with the Acute Physiology And Chronic Health Evaluation (APACHE II) score, C-reactive protein (CRP) and PCT serum concentrations and IAP at 24 h from admission. PCT was measured three times in the 1st week of disease and three times afterward, while IAP was measured daily. PCT and IAP values correlated with each other, and also compared with APACHE II score and CRP values.


RESULTS
PCT, IAP, CRP values and APACHE II score at 24 h after hospital admission were significantly elevated in patients with SAP. There was significant correlation between PCT and IAP values measured at 24 h of admission, and between maximal PCT and IAP values. Sensitivity/specificity for predicting AP severity at 24 h after admission was 89%/69% for APACHE II score, 75%/86% for CRP, 86%/63% for PCT and 75%/77% for IAP.


CONCLUSIONS
Increased IAP was accompanied by increased PCT serum concentration in patients with AP. PCT and IAP can both be used as early markers of AP severity.
Clinic for General Surgery, Military Medical Academy, Crnotravska 17, 11 000 Belgrade, Serbia. bezmarevicm@gmail.com
Mihailo
M
Bezmarevic
Darko
D
Mirkovic
Ivan
I
Soldatovic
Dusica
D
Stamenkovic
Nikola
N
Mitrovic
Nenad
N
Perisic
Ivan
I
Marjanovic
Sasa
S
Mickovic
Menelaos
M
Karanikolas
D018806:APACHE; D000005:Abdomen; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D059325:Intra-Abdominal Hypertension / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000503:physiopathology*; D011312:Pressure; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012720:Severity of Illness Index
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide