The value of procalcitonin at predicting the severity of acute pancreatitis and development of infected pancreatic necrosis

Systematic review

Reza Mofidi, Stuart A. Suttie, Pradeep V. Patil, Simon Ogston, Rowan W. Parks

    Research output: Contribution to journalReview article

    103 Citations (Scopus)

    Abstract

    Background. Many studies have evaluated serum levels of procalcitonin (PCT) as a predictor in the development of severe acute pancreatitis (SAP) and infected pancreatic necrosis (H-W). This study assesses the value of PCT as a marker of development of SAP and IPN.

    Methods. Medline, Web of Science, the Cochrane clinical trials register, and international conference proceedings were searched systematically for prospective studies, which evaluated the usefulness of PCT as a marker of SAP and IPN. The sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated for each study, and the study quality and heterogeneity among the studies were evaluated.

    Results. Twenty-four of 59 studies identified were included in data extraction. The sensitivity and specificity of PCT for development of SAP were 0.72 and 0.86, respectively (area under the curve [AUC] = 0.87; DOR = 14.9; 95% confidence interval [CI] = 5.6-39.8), albeit with a significant degree of heterogeneity Q = 28.56, P .01). The sensitivity and specificity of PCT for prediction of infected pancreatic necrosis were 0.80 and 0.91 (AUC = 0.91; DOR = 28.3; 95% CI = 13.8-58.3) with no significant heterogeneity Q = 7.83, P = .18). No significant heterogeneity was observed among the studies when only higher quality studies (AUC = 0.91; DOR = 30.7; 95% CI = 10. 7-87.8) or studies that used a cutoff PCT level >0.5 ng/mL (AUC = 0.88, 32.8; 95% CI = 10.1-106.6) were included.

    Conclusion. Serum measurements of PCT may be valuable in predicting the severity of acute pancreatitis and the risk of developing infected pancreatic necrosis. (Surgery 2009;146:72-81.)

    Original languageEnglish
    Pages (from-to)72-81
    Number of pages10
    JournalSurgery
    Volume146
    Issue number1
    DOIs
    Publication statusPublished - Jul 2009

    Keywords

    • ACUTE NECROTIZING PANCREATITIS
    • C-REACTIVE PROTEIN
    • CONTROLLED CLINICAL-TRIAL
    • SERUM PROCALCITONIN
    • INFLAMMATORY RESPONSE
    • DIAGNOSTIC RELEVANCE
    • ANTIBIOTIC-TREATMENT
    • METAANALYSIS
    • DYSFUNCTION
    • MULTICENTER

    Cite this

    Mofidi, Reza ; Suttie, Stuart A. ; Patil, Pradeep V. ; Ogston, Simon ; Parks, Rowan W. / The value of procalcitonin at predicting the severity of acute pancreatitis and development of infected pancreatic necrosis : Systematic review. In: Surgery. 2009 ; Vol. 146, No. 1. pp. 72-81.
    @article{f0f093ce25ea4325951c8f9e35ca00ae,
    title = "The value of procalcitonin at predicting the severity of acute pancreatitis and development of infected pancreatic necrosis: Systematic review",
    abstract = "Background. Many studies have evaluated serum levels of procalcitonin (PCT) as a predictor in the development of severe acute pancreatitis (SAP) and infected pancreatic necrosis (H-W). This study assesses the value of PCT as a marker of development of SAP and IPN.Methods. Medline, Web of Science, the Cochrane clinical trials register, and international conference proceedings were searched systematically for prospective studies, which evaluated the usefulness of PCT as a marker of SAP and IPN. The sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated for each study, and the study quality and heterogeneity among the studies were evaluated.Results. Twenty-four of 59 studies identified were included in data extraction. The sensitivity and specificity of PCT for development of SAP were 0.72 and 0.86, respectively (area under the curve [AUC] = 0.87; DOR = 14.9; 95{\%} confidence interval [CI] = 5.6-39.8), albeit with a significant degree of heterogeneity Q = 28.56, P .01). The sensitivity and specificity of PCT for prediction of infected pancreatic necrosis were 0.80 and 0.91 (AUC = 0.91; DOR = 28.3; 95{\%} CI = 13.8-58.3) with no significant heterogeneity Q = 7.83, P = .18). No significant heterogeneity was observed among the studies when only higher quality studies (AUC = 0.91; DOR = 30.7; 95{\%} CI = 10. 7-87.8) or studies that used a cutoff PCT level >0.5 ng/mL (AUC = 0.88, 32.8; 95{\%} CI = 10.1-106.6) were included.Conclusion. Serum measurements of PCT may be valuable in predicting the severity of acute pancreatitis and the risk of developing infected pancreatic necrosis. (Surgery 2009;146:72-81.)",
    keywords = "ACUTE NECROTIZING PANCREATITIS, C-REACTIVE PROTEIN, CONTROLLED CLINICAL-TRIAL, SERUM PROCALCITONIN, INFLAMMATORY RESPONSE, DIAGNOSTIC RELEVANCE, ANTIBIOTIC-TREATMENT, METAANALYSIS, DYSFUNCTION, MULTICENTER",
    author = "Reza Mofidi and Suttie, {Stuart A.} and Patil, {Pradeep V.} and Simon Ogston and Parks, {Rowan W.}",
    note = "MEDLINE{\circledR} is the source for the MeSH terms of this document.",
    year = "2009",
    month = "7",
    doi = "10.1016/j.surg.2009.02.013",
    language = "English",
    volume = "146",
    pages = "72--81",
    journal = "Surgery",
    issn = "0039-6060",
    publisher = "Elsevier",
    number = "1",

    }

    The value of procalcitonin at predicting the severity of acute pancreatitis and development of infected pancreatic necrosis : Systematic review. / Mofidi, Reza; Suttie, Stuart A.; Patil, Pradeep V.; Ogston, Simon; Parks, Rowan W.

    In: Surgery, Vol. 146, No. 1, 07.2009, p. 72-81.

    Research output: Contribution to journalReview article

    TY - JOUR

    T1 - The value of procalcitonin at predicting the severity of acute pancreatitis and development of infected pancreatic necrosis

    T2 - Systematic review

    AU - Mofidi, Reza

    AU - Suttie, Stuart A.

    AU - Patil, Pradeep V.

    AU - Ogston, Simon

    AU - Parks, Rowan W.

    N1 - MEDLINE® is the source for the MeSH terms of this document.

    PY - 2009/7

    Y1 - 2009/7

    N2 - Background. Many studies have evaluated serum levels of procalcitonin (PCT) as a predictor in the development of severe acute pancreatitis (SAP) and infected pancreatic necrosis (H-W). This study assesses the value of PCT as a marker of development of SAP and IPN.Methods. Medline, Web of Science, the Cochrane clinical trials register, and international conference proceedings were searched systematically for prospective studies, which evaluated the usefulness of PCT as a marker of SAP and IPN. The sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated for each study, and the study quality and heterogeneity among the studies were evaluated.Results. Twenty-four of 59 studies identified were included in data extraction. The sensitivity and specificity of PCT for development of SAP were 0.72 and 0.86, respectively (area under the curve [AUC] = 0.87; DOR = 14.9; 95% confidence interval [CI] = 5.6-39.8), albeit with a significant degree of heterogeneity Q = 28.56, P .01). The sensitivity and specificity of PCT for prediction of infected pancreatic necrosis were 0.80 and 0.91 (AUC = 0.91; DOR = 28.3; 95% CI = 13.8-58.3) with no significant heterogeneity Q = 7.83, P = .18). No significant heterogeneity was observed among the studies when only higher quality studies (AUC = 0.91; DOR = 30.7; 95% CI = 10. 7-87.8) or studies that used a cutoff PCT level >0.5 ng/mL (AUC = 0.88, 32.8; 95% CI = 10.1-106.6) were included.Conclusion. Serum measurements of PCT may be valuable in predicting the severity of acute pancreatitis and the risk of developing infected pancreatic necrosis. (Surgery 2009;146:72-81.)

    AB - Background. Many studies have evaluated serum levels of procalcitonin (PCT) as a predictor in the development of severe acute pancreatitis (SAP) and infected pancreatic necrosis (H-W). This study assesses the value of PCT as a marker of development of SAP and IPN.Methods. Medline, Web of Science, the Cochrane clinical trials register, and international conference proceedings were searched systematically for prospective studies, which evaluated the usefulness of PCT as a marker of SAP and IPN. The sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated for each study, and the study quality and heterogeneity among the studies were evaluated.Results. Twenty-four of 59 studies identified were included in data extraction. The sensitivity and specificity of PCT for development of SAP were 0.72 and 0.86, respectively (area under the curve [AUC] = 0.87; DOR = 14.9; 95% confidence interval [CI] = 5.6-39.8), albeit with a significant degree of heterogeneity Q = 28.56, P .01). The sensitivity and specificity of PCT for prediction of infected pancreatic necrosis were 0.80 and 0.91 (AUC = 0.91; DOR = 28.3; 95% CI = 13.8-58.3) with no significant heterogeneity Q = 7.83, P = .18). No significant heterogeneity was observed among the studies when only higher quality studies (AUC = 0.91; DOR = 30.7; 95% CI = 10. 7-87.8) or studies that used a cutoff PCT level >0.5 ng/mL (AUC = 0.88, 32.8; 95% CI = 10.1-106.6) were included.Conclusion. Serum measurements of PCT may be valuable in predicting the severity of acute pancreatitis and the risk of developing infected pancreatic necrosis. (Surgery 2009;146:72-81.)

    KW - ACUTE NECROTIZING PANCREATITIS

    KW - C-REACTIVE PROTEIN

    KW - CONTROLLED CLINICAL-TRIAL

    KW - SERUM PROCALCITONIN

    KW - INFLAMMATORY RESPONSE

    KW - DIAGNOSTIC RELEVANCE

    KW - ANTIBIOTIC-TREATMENT

    KW - METAANALYSIS

    KW - DYSFUNCTION

    KW - MULTICENTER

    UR - http://www.scopus.com/inward/record.url?scp=67349213202&partnerID=8YFLogxK

    U2 - 10.1016/j.surg.2009.02.013

    DO - 10.1016/j.surg.2009.02.013

    M3 - Review article

    VL - 146

    SP - 72

    EP - 81

    JO - Surgery

    JF - Surgery

    SN - 0039-6060

    IS - 1

    ER -