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Dynamics of Serum Procalcitonin Can Predict Outcome in Patients of Infected Pancreatic Necrosis: A Prospective Analysis

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Abstract

Background

Timely intervention can alter outcome in patients of infected pancreatic necrosis (IPN) but lacks adequate biomarker. Role of serum procalcitonin (PCT) in the management of IPN is understudied, and hence, this study was planned.

Methodology

All patients of acute pancreatitis with IPN without prior intervention were included. Baseline demographic, radiological and laboratory parameters were documented. PCT was measured at baseline, prior to intervention, and thereafter every 72 h. Patients were grouped into those having baseline PCT < 1.0 ng/mL and those with PCT ≥ 1.0 ng/mL and various outcome measures were compared.

Results

Of the 242 patients screened, 103 cases (66 males; 64.1%) with IPN were grouped into 2: PCT < 1.0 ng/mL (n = 29) and PCT ≥ 1.0 ng/mL (n = 74). Patients with baseline PCT ≥ 1.0 ng/mL had significantly more severe disease scores. 16 out of 19 patients with rise in PCT on day-7 post-intervention expired. PCT ≥ 1.0 ng/mL group had higher need for ICU (p = 0.001) and mortality (p = 0.044). PCT > 2.25 ng/mL (aOR 22.56; p = 0.013) at baseline and failure in reduction of PCT levels to < 60% of baseline at day-7 post-intervention (aOR 53.76; p = 0.001) were significant mortality predictors.

Conclusion

Baseline PCT > 1.0 ng/mL is associated with poor outcome. PCT > 2.25 ng/mL and failure in reduction of PCT levels to < 60% of its baseline at day-7 post-intervention can identify high-mortality risk patients.

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Acknowledgments

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Author notes

  1. Jayanta Samanta and Jahnvi Dhar be considered as co-first authors.

Authors and Affiliations

  1. Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

    Jayanta Samanta, Jahnvi Dhar, Chhagan Lal Birda, Pankaj Gupta, Saroj Kant Sinha & Rakesh Kochhar

  2. Department of GI Surgery, Post Graduate Institute of Medical Education and Research, India, Chandigarh

    Thakur Deen Yadav & Vikas Gupta

  3. Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India

    Jayanta Samanta

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Contributions

Guarantor of the article: JS. JS and JD: conception and design, data interpretation, data analysis, drafting the work, patient care and final approval. CLB, PG: data interpretation, patient care, intellectual review of the work and final approval. TDY, VG: data interpretation, intellectual review of the work, patient care and final approval. SKS, RK: data interpretation, critical review of the work and final approval. All authors have approved the final version of the article including the authorship list.

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Correspondence to Jayanta Samanta.

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Online Resource table 1: Factors predicting mortality in patients with acute pancreatitis

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Samanta, J., Dhar, J., Birda, C.L. et al. Dynamics of Serum Procalcitonin Can Predict Outcome in Patients of Infected Pancreatic Necrosis: A Prospective Analysis. Dig Dis Sci 68, 2080–2089 (2023). https://doi.org/10.1007/s10620-022-07758-4

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