To Access the Role of Serum Procalcitonin in Predicting the Severity of Acute Pancreatitis

Background Acute Pancreatitis remains a common disorder with devastating consequences in severe form of disease. In this study we assessed serum procalcitonin for early prediction of severity of acute pancreatitis and compared it with multiple scoring systems and biomarkers. Objective This is a prospective comparative study in which 125 patients with diagnosis of acute pancreatitis were enrolled. All blood samples and imaging studies were obtained within 24-72 hours of admission and the severity was predicted. Method This is a prospective comparative study in which 125 patients with diagnosis of acute pancreatitis were enrolled. All blood samples and imaging studies were obtained within 24-72 hours of admission and the severity was predicted. Result Acute pancreatitis was graded severe in 54 patients and mild in 71 patients as per the Atlanta criteria. Receiver operating characteristic curve showed the area under curve of serum procalcitonin was higher (area under curve: 0.887, Confidence interval: 0.825-0.948) compared to computed tomography severity index scoring system (Area under curve: 0.841, Confidence interval: 0.771-0.911), Ranson's score (Area under curve: 0.796, Confidence interval: 0.715-0.876) and C-reactive protein (Area under curve: 0.717, Confidence interval: 0.628-0.8.7) in predicting the severity of acute pancreatitis. The best cut-off value of serum procalcitonin to predict severe acute pancreatitis was 0.9 ng/ml with 92.6% sensitivity, 80.3% specificity. The accuracy of serum procalcitonin (85.6%) was better than computed tomography severity index score (73.6 %), Ranson's score (76.8%) and C-reactive protein (64.8%). Conclusion Multifactorial scoring systems are complex and hard to use in clinical basis. Serum procalcitonin can be used as a promising single biomarker, easily done in all setup with better accuracy. And it is comparable to computed tomography severity index and Ranson's scores in earlier prediction of severity of acute pancreatitis.