title: Pancreatic stone protein predicts outcome in patients with peritonitis in the ICU.
abstract: OBJECTIVE
  To determine the value of pancreatic stone protein in predicting sepsis-related postoperative complications and death in the ICU.
  
  
  METHODS
  A prospective cohort study of postoperative patients admitted to the ICU. Blood samples for analysis were taken within 3 hours from admission to the ICU including pancreatic stone protein, white blood cell counts, C-reactive protein, interleukin-6, and procalcitonin. The Mannheim Peritonitis Index and Acute Physiology and Chronic Health Evaluation II clinical scores were also determined. Univariate and multivariate analyses were performed to determine the diagnostic accuracy and independent predictors of death in the ICU [Clinicaltrials.gov, NCT01465711].
  
  
  METHODS
  An adult medical-surgical ICU in a teaching hospital in Germany.
  
  
  METHODS
  Ninety-one consecutive postoperative patients with proven diagnosis of secondary peritonitis admitted to the ICU were included in the study from August 17, 2007, to February 8, 2010.
  
  
  METHODS
  Peripheral vein blood sampling.
  
  
  RESULTS
  Univariate analysis demonstrated that pancreatic stone protein has the highest diagnostic accuracy for complications and is the best predictor for death in the ICU. Pancreatic stone protein had the highest overall efficacy in predicting death with an odds ratio of 4.0 vs. procalcitonin (odds ratio 3.2), interleukin-6 (odds ratio 2.8), C-reactive protein (odds ratio 1.3), and WBCs (odds ratio 1.4). By multivariate analysis, pancreatic stone protein was the only independent predictor of death.
  
  
  CONCLUSIONS
  In a population of patients with sepsis-related complications, serum-pancreatic stone protein levels demonstrate a high diagnostic accuracy to discriminate the severity of peritonitis and to predict death in the ICU. This test could be of value in the clinical diagnosis and therapeutic decision making in the ICU.
authors: Department of Surgery, Division of Experimental Surgery, Otto-von-Guericke University, Magdeburg, Germany.
authors: Raphael
authors: R
authors: Gukasjan
authors: Dimitri Aristotle
authors: DA
authors: Raptis
authors: Hans-Ulrich
authors: HU
authors: Schulz
authors: Walter
authors: W
authors: Halangk
authors: Rolf
authors: R
authors: Graf
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D015331:Cohort Studies; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D005858:Germany; D006801:Humans; D007362:Intensive Care Units; D015850:Interleukin-6 / Q000097:blood; D051847:Lithostathine / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000097:blood / Q000175:diagnosis* / Q000401:mortality*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D015850:Interleukin-6; D051847:Lithostathine; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide