Comparison of Serum Procalcitonin Levels with Glasgow Score to Predict Severity of Acute Biliary Pancreatitis

Abstract

Objective: To compare the diagnostic accuracy of serum procalcitonin levels versus the Glasgow score in predicting the severity of acute biliary pancreatitis. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of General Surgery, Combined Military Hospital, Rawalpindi Pakistan, Dec 2021 tonApr 2022. Methodology: One hundred twenty-three patients suffering from acute biliary pancreatitis were included in the study. The severity of pancreatitis was established based on contrast-enhanced computed tomography of the abdomen as per the Balthazar score. All patients were assessed using the Glasgow score for pancreatitis and received a test for serum procalcitonin levels at 24-hours post-admission. Results: The mean age of our study sample was 49.03±8.88 years. The Glasgow score predicted that 51(41.5%) had severe disease and had a sensitivity of 61.4%, a specificity of 75.8% and an identical diagnostic accuracy of 69.1% for detecting severe acute biliary pancreatitis. Serum Procalcitonin levels at a cut-off of 0.5ng/mL as an indicator of the severity of pancreatitis had a sensitivity of 75.4%, a specificity of 63.6% and a diagnostic accuracy of 69.1%, which estimated that 67(54.5%) patients had severe disease. Conclusion: Both serum procalcitonin levels and the Glasgow score were equally effective in predicting the severity of acute biliary pancreatitis. However, neither testing modality was sufficiently accurate in predicting the presence of severe acute biliary pancreatitis.

Keywords

• Glasgow score
• Pancreatitis
• Procalcitonin