635 Dual Modality Drainage for Infected and Symptomatic Walled off Pancreatic Necrosis: Clinical Outcomes in 98 Consecutive Patients

Abstract

75 patients (87.2%) had severe disease {Atlanta (1992)}, and persistent organ failure was observed in 30 (34.9%) patients. The mean CT severity index (CTSI) score was 7.4±2.25. Twenty two (25.6%) patients underwent intervention (percutaneous radiologic catheter/ endoscopic drainage) for the local complications. Nine patients (10.5%) succumbed to their illness. Themean plasmaOPN levels on admissionwere 13.6±8.10 ng/mL (normal: 3.58±1.43 ng/mL). The mean CRP levels on admission were 57.8±10.7 mg/L (normal ,10mg/L). Plasma OPN level were significantly higher in patients who developed persistent organ failure (p,0.001), necrosis (p=0.015), CTSI≥7 (P=0.006) and severe pancreatitis (p=0.015) compared to those who did not. However, OPN levels were similar between non survivors & survivors (p=0.733) & those who did & did not require intervention (p=0.968). CRP levels were significantly higher in patients with persistent organ failure (p ,0.001) compared to those who did not (Table 1). However, CRP levels were comparable between survivors & non survivors (p=0.866), with & without necrosis (p=0.986), with and without severe disease (p=0.986) & those who did & did not require intervention (p=0.669) On ROC curve, OPN levels of 12.1 ng/mL could predict necrosis with a sensitivity and specificity of 65% and 64% (AUROC: 0.733), of 12.1 ng/mL could predict severe disease with a sensitivity and specificity of 65% and 64% (AUROC: 0.733), and levels of 16.3 ng/mL could predict POF with a sensitivity and specificity of 66% and 66% (AUROC: 0.721). CRP levels at 57.6 mg/L could predict POF with a sensitivity and specificity of 53% and 54% (AUROC: 0.550). Conclusion: Plasma OPN level at admission is a useful predictor of the severity and complications in AP. Plasma OPN and CRP Levels and Relation to the Outcome Parameters in Acute Pancreatitis