C-reactive protein and Procalcitonin Levels in Acute Pancreatitis: A Study in A Tertiary Care Hospital in Bangladesh

Abstract

Background: Acute pancreatitis is an inflammatory disease of highly variable severity, ranging from mild cases with low mortality to severe cases with high mortality. Numerous biomarkers have been studied as potential early predictors of the severity of this disease so that treatment can be optimally tailored to prevent complications. C-reactive protein and procalcitonin are the most promising single markers for assessment of major complications and prognosis. Aim of the Study: The aim of this study was to evaluate C-reactive protein and procalcitonin levels in acute pancreatitis. Methods: This was a prospective observational study. The study was conducted on 35 admitted patients with diagnosis of acute pancreatitis at BIRDEM General Hospital, Dhaka, Bangladesh from October 2016 to April 2017. Complete blood count, serum amylase, serum lipase, C-reactive protein and serum procalcitonin values were observed. Data were collected from history, clinical findings and investigations. Proper written consents were taken from all the participants before data collection. A predesigned questioner was used in data collection. All data were processed, analyzed and disseminated by using MS Excel and SPSS version 23 program as per necessity. Results: Among the parameters of the patients, P values of CRP were 0.047 and procalcitonin (PCT) was 0.032, less than 0.05 which were statistically significant. These studies have shown that, serum procalcitonin (PCT) is a good marker for predicting severity and development of organ failure in acute pancreatitis and it is superior to serum C reactive protein. The negative predictive values and positive predictive value for the procalcitonin were higher (90% and 53% respectively) than the respective values for CRP (89% and 47% respectively). The values of PCT showed high sensitivity of 91% and specificity of 81% in predicting severe acute pancreatitis. The negative predictive value was high (90%) indicating that with a negative test result ...