C-reactive protein and procalcitonin - laboratory markers of degrees of severity and complications of an acute necrotic pancreatitis

Keywords: acute necrotic pancreatitis; infective complications; C-reactive protein; procalcitonin.

Abstract

Objective. To conduct comparative estimation of efficacy of C-reactive protein and procalcitonin as laboratory markers for stratification of the patients severity state suffering an acute necrotic pancreatitis.

Materials and methods. Prospective cohort investigation, including 151 patients with an acute necrotic pancreatitis, was conducted. Clinical, laboratory and bacteriological investigations were accomplished. The levels of C-reactive protein and procalcitonin were determined in the blood plasm.

Results. The necrotic accumulations infectioning was diagnosed in 89 (58.9%) patients: local purulent complications - in 27, sepsis - in 33,septic shock - in 29. In 62 patients with sterile pancreonecrosis a C-reactive protein concentration have raised from (5.6 ± 0.89) to (206 ± 29) mg/l (p˂0.001). Development of purulent-septic complications was accompanied by significant and trustworthy (p<0.01) elevation of procalcitonin concentration: in the patients with sepsis - up to (5.05 ± 0.92) ng/ml, in the patients with septic shock - up to (7.25 ± 2.15) ng/ml.

Conclusion. Simultaneous measurement of levels of C-reactive protein and procalcitonin in the blood plasm in patients, suffering acute necrotic pancreatitis, gives permission to determine the inflammatory process character and stratify the disease severity in its early terms.

Author Biographies

O. V. Rotar, Bukovyna State Medical University, Chernivtsi

Rotar Oleksandr Vasylovych - MD, PhD (Med), Associate Professor
Department of General Surgery,
Bukovinian State Medical University»,
2 Teatralna Sq., 58000,
oleksandr.rotar@gmail.com
orcid.org/0000-0002-9434-0377

I. V. Khomiak, Shalimov National Institute of Surgery and Transplantation, Kyiv

Khomiak Igor Vasylovych - MD, Doctor of Sci (Med), Professor,
Head Scientific Researcher
Department of Pancreas Surgery and Bile Ducts Reconstruction Surgery,
A.A. Shalimov National Institute of Surgery and Transplantology,
Kyiv, 30 Heroyv Sevastopolya Str., 03680,
md.khomiak@gmail.com
orcid.org/0000-0002-3299-7840

V. I. Rotar, Bukovyna State Medical University, Chernivtsi

Rotar Vasyl Ivanovych - MD, PhD (Med), Associate Professor
Department of Anesthesiology and Reanimatology,
Bukovinian State Medical University,
2 Teatralna Sq., 58000,
rotar.v@i.ua
orcid.org/0000-0002-3467-0024

A. I. Khomiak, Shalimov National Institute of Surgery and Transplantation, Kyiv

Khomiak Andrii Igorovich - MD, Scientific Researcher
Department of Pancreas Surgery and Bile Ducts Reconstruction Surgery,
A. A. Shalimov National Institute of Surgery and Transplantology,
Kyiv, 30 Heroyv Sevastopolya Str., 03680,
kh.ndrew@gmail.com
orcid.org/0000-0003-0974-4965

S. I. Railianu, Bukovyna State Medical University, Chernivtsi

Railianu Svitlana Ilivna - MD, Assistant of Department of General Surgery,
Bukovinian State Medical University,
2 Teatralna Sq., 58000,
aroh@ua.fm
orcid.org/0000-0001-7367-3108

References

Usenko OY, Kopchak VM, Khomiak IV, Khomiak AI, Malik AV. Results of surgical treatment of paraduodenal (groove) pancreatitis. Klin Khir. 2019;85(11):5-8. doi:10.26779/2522-1396.2018.11.05

Dronov OI, Nastashenko IL, Susak YM, Tsymbalyuk RS, Tyulyukin IO. Surgical treatment of patients, suffer in an acute biliary pancreatitis and biliary hypertension. Klin Khir. 2018;85(4):5-8. doi: 10.26779/2522-1396.2018.04.05.

Yang CJ, Chen J, Phillips AR, Windsor JA, Petrov MS. Predictors of severe and critical acute pancreatitis: a systematic review. Dig Liv Dis. 2014;46(5):446-51. doi:10.1016/j.dld.2014.01.158.

Holub M, Džupová O, Růžková M, Stráníková A, Bartáková E, Máca T, et al. Selected Biomarkers Correlate with the Origin and Severity of Sepsis. Med Infl. 2018;2018:7028267. doi:10.1155/2018/7028267.

Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immun. 2018;9:754. doi:10.3389/fimmu.2018.00754.

Twomey M, Fleming H, Moloney F, Murphy K, Crush L, O'Neill S, et al. C-reactive protein and radiographic findings of lower respiratory tract infection in infants. World J Rad. 2017;9(4):206-11. doi:10.4329/wjr.v9.i4.206.

Covington EW, Roberts MZ, Dong J. Procalcitonin Monitoring as a Guide for Antimicrobial Therapy: A Review of Current Literature. Pharmacotherapy. 2018;38(5):569-81. doi:10.1002/phar.2112.

Published
2020-06-26
Section
General Problems of Surgery