Utilizing Multiparameter Scores and Procalcitonin as Prognosis Markers for the Degree of Severity of Acute Pancreatitis

ABSTRACT: Aim: Corroborating the Ranson, Marshall, computer tomography severity index (EPIC score) multiparameter tests with the biological marker procalcitonin in order to establish the degree of severity of acute pancreatitis for therapeutic management and rate of complications. Material and method: 20 patients were surveyed, diagnosed with acute pancreatitis in the surgery clinic of the Military Emergency Hospital Dr. Ștefan Odobleja, between 2016-2017, with the aim of determining the clinical, etiological and severity diagnosis by corroborating the multiparameter scores with the plasma level of procalcitonin. Results: Following the use of multiparameter scores to identify the degree of severity of acute pancreatitis, we established that the best prediction is achieved by the Ranson score and the computer tomography severity index (EPIC score), with an accuracy of 90% . As for the values of the correlation coefficient, this was highly significant when correlating Ranson score and procalcitonin (r = 0.918). Other correlations were also highly significant, with values of r = 0.797 when correlating EPIC score and procalcitonin, and r = 0.736 when correlating Marshall score with procalcitonin. Conclusion: Our study achieved an early identification of the severe form of acute pancreatitis, by using the multiparameter tests and the biologic marker procalcitonin, allowing for the appropriate therapy to be implemented and thus decreasing the complication rate of this pathological entity. Levels of serum procalcitonin exceeded the normal limit of 2 ng/ml for 37.5% of the intermediate - severe form patients, and for 100% of the severe form patients. The levels of procalcitonin were highly correlated with the Ranson score, with a slightly lower correlation for the Marshall and EPIC scores.