Serum procalcitonin useful biomarker for high-risk patients with infected pancreatic necrosis

A new study revealed that serum procalcitonin (PCT) can be used as a biomarker for timely intervention and altering the outcome in infected pancreatic necrosis (IPN). It can be used as a tool to identify high-mortality risk patients and also patients with poorer outcomes based on the baseline levels and post-intervention levels. The study results were published in the journal Digestive Diseases and Sciences. 

In patients with infected pancreatic necrosis (IPN), timely intervention can improve outcomes if there is an adequate biomarker to identify the risk. As the role of serum procalcitonin (PCT) in the management of IPN is understudied, researchers from Chandigarh, India conducted a study to assess the role of serum procalcitonin (PCT) in IPN management. 

Participants included all patients with acute pancreatitis with IPN without prior intervention. Baseline demographic, radiological, and laboratory parameters were documented. PCT was measured at baseline, before the intervention, and thereafter every 72 h. Patients were grouped into those having baseline PCT < 1.0 ng/mL and those with PCT ≥ 1.0 ng/mL and various outcome measures were compared. 

Results: 

• Of the 242 patients screened, 103 cases (66 males; 64.1%) with IPN were Identified. There were 66 (64.1%) males.
• They have been grouped into 2 groups PCT < 1.0 ng/mL (n = 29) and PCT ≥ 1.0 ng/mL (n = 74).
• Significantly more severe disease scores were identified in patients with baseline PCT ≥ 1.0 ng/mL.
• High mortality was seen in 16 out of 19 patients with a rise in PCT on day 7 post-intervention.
• There was a higher need for ICU (p = 0.001) and high mortality (p = 0.044) in patients with PCT ≥ 1.0 ng/mL group. 
• PCT > 2.25 ng/mL at baseline and failure in reduction of PCT levels to < 60% of baseline at day 7 post-intervention were significant mortality predictors. 

Thus, the study showed that PCT levels can be used to identify high-mortality risk patients with IPN. 

Further reading: Samanta, J., Dhar, J., Birda, C.L. et al. Dynamics of Serum Procalcitonin Can Predict Outcome in Patients of Infected Pancreatic Necrosis: A Prospective Analysis. Dig Dis Sci (2022). https://doi.org/10.1007/s10620-022-07758-4