Slovenská chirurgia 3/2014

Importance of prognostic factors in estimate the course of acute pancreatitis

Background: Wide range of acute pancreatitis symptoms led to the establishment and development of scoring systems and biochemical markers because early assessment of severity of a patient’s state can strongly influence further therapeutic decision-making and overall prognosis and can indicate patients benefiting from intensive care and monitoring. Material and Methods:Prospective study was designed to evaluate CRP, PCT, Ranson’s and Apache II score for the diagnosis of severity in the acute pancreatitis during the follow-up of enrolled patients admitted to The Surgical Clinic of The Faculty Hospital in Trnava from 1 st January 2009 till 31 st December 2009. Results:Of the 67 study participants admitted to the above mentioned hospital, 51 (75 %) had mild and 16 (25 %) had severe pancreatitis. From monitoring the predictive clinical value of the phenomena assassing severity of the acute pancreatitis follow-up, we found out statistical dependence on PCT, Ranson’s and Apache II score; we did not find it out for CRP. Specificity of PCT was 96 %, CRP 84 %, Ranson’s score 73 % and Apache II 71 %. Sensitivity of PCT reached 75 %, CRP 38 %, Ranson’s and Apache II score 75 %. Monitoring predictive clinical value of the phenomena estimating mortality, we again evaluated statistical dependence for PTC, Ranson’s criteria and Apache II score, we did not manage to evaluate it for CRP. Specificity of PCT was 88 %, CRP 81 %, Ranson’s criteria 68 % and Apache II score 68 %. Sensitivity of PCT, Ranson’s criteria and Apache II score reached 87,5 %, CRP 37,5 %. Conclusion:On the basis of our observation, at the moment of admission of a patient with acute pancreatitis, procalcitonin is the most suitable of all possibilities when considering the severity of the follow-up and mortality of AP.

Keywords: acute pancreatitis, procalcitonin, C-reactive protein, Apache II score, Ranson’s criteria, mortality.