The effect of procalcitonin and immature granulocyte ratio in predicting the development of acute necrotizing pancreatitis: evidence from 582 cases.

Abstract

Acute pancreatitis (AP) is one of the diseases that surgical clinics deal with the most. While mortality rates are approximately 1% in all cases, this rate may increase to 15% in pancreatic necrosis cases. Therefore, early diagnosis and treatment are very important in necrotizing pancreatitis. Our aim in this study is to present the guiding effectiveness of procalcitonin and immature granulocyte ratios (IG%) in planning the early diagnosis and treatment of acute necrotizing pancreatitis. 582 patients hospitalized in our clinic with the diagnosis of acute pancreatitis were included in this study. All patients were divided into two groups as acute edematous pancreatitis (AEP) and acute necrotizing pancreatitis (ANP) according to tomography results. White blood cell (WBC) count, procalcitonin, IG%, C-reactive protein (CRP), amylase and lipase, albumin, CRP/albumin levels were recorded. The differences between the two groups were analyzed statistically. According to the results of contrast-enhanced abdominal tomography (CECT), 525 patients were diagnosed with AEP and 57 with ANP. WBC, CRP, procalcitonin, IG and CRP/albumin were found to be significantly higher in ANP patients when compared to AEP (p<0.0001). According to the ROC analysis result, procalcitonin (AUROC: 0.999), IG% (AUROC: 0.995), WBC count (AUROC: 0.841), CRP (AUROC: 0.947), albumin (AUROC: 0.862), and CRP/albumin (AUROC: 0.946) ratio were markers that could be used for early prediction of ANP. Early diagnosis of ANP can reduce morbidity and mortality. Procalcitonin and IG% levels can be easily accessible and effective markers in the early diagnosis of ANP and in the planning of treatment.