Biological markers of severity in acute pancreatitis

Abstract

None of the definitions of severity used in acute pancreatitis (AP) is ideal. Many of the scoring systems used to predict and measure its severity are complex, cumbersome and inaccurate. Aim: to evaluate the usefulness of the most commonly used early markers for predicting severity, necrosis and mortality in patients with AP, and the need for surgery or Intensive Care Unit (ICU) admission. Material&methods: Prospective study was performed from March 2009 to August 2010 based on patients diagnosed with AP seen consecutively at a secondary hospital. The early prognostic markers used were Apache II score ≥8 and Ranson's score ≥3, RCP>120mg/l and Ht>44% in the first 24 hours. Results: 131 patients were prospectively enrolled. Median age was 63 years, 60% were men. The most frequent etiology of AP was biliary (68%). Fifteen patients were admitted to the ICU (11.6%) and five (3.9%) required surgery. Twelve patients (9.2%) had necrosis on CT. Four patients (3%) died , all of them in the Severe AP group. Only hematocrit>44 was predictor of mortality in univariate analysis. Conclusion: hematocrit ≥ 44% was a significant predictor of mortality. The other indicators present limitations for predicting severity, necrosis and mortality, especially in the first 24 hours. © Versita Sp. z o.o.