Relevance of Procalcitonin Levels as a Marker of Severity and Predictor of Mortality, Initiation and Duration of Antibiotics in Patients Admitted with Acute Pancreatitis: A Retrospective Cohort Study

Abstract

Baldeep Kaur Mann,1 Janpreet Singh Bhandohal,1 Ishaan Kalha,2 Kasey Fox,1 Brian Jean3 1Division of Hospital Medicine, Department of Medicine, Kern Medical Center, Bakersfield, CA, USA; 2Division of Gastroenterology, Department of Medicine, Kern Medical Center, Bakersfield, CA, USA; 3Biostatistician, Professor Emeritus, Kern Medical Center, Bakersfield, CA, USACorrespondence: Baldeep Kaur Mann, Division of Hospital Medicine, Department of Medicine, Kern Medical Center, 1700 Mount Vernon Ave, Bakersfield, CA, 93306, USA, Email [email protected]: Procalcitonin levels have been studied to predict the benefit of adding antibiotics in a patient with acute pancreatitis. Through this study, we are searching for any possible correlation between serum procalcitonin levels and the severity of acute pancreatitis (included acute on chronic cases) to determine whether procalcitonin levels can predict a benefit from antibiotic therapy in acute pancreatitis.Methods: This is a retrospective cohort study involving patients with acute pancreatitis and acute on chronic pancreatitis. We included all hospitalized patients admitted to Kern Medical from January 2020 to October 2022 with a diagnosis of acute pancreatitis in a consecutive manner. The primary outcome studied was mortality related to the pancreatitis episode. Logistic regression was used to control numerous confounders.Results: Based on univariate analysis of procalcitonin, we found starting antibiotics on the day of admission statistically significant. We also found the median differences in mortality to be mildly significant (difference = 0.79, p = 0.0640) based on procalcitonin values. In a multivariate analysis of ln(procalcitonin), we found lipase (p = 0.0249), duration of antibiotics (p = 0.0009), multi-organ failure (p = 0.0045) to be statistically significant, and lactate being mildly significant in the multivariate model (p = 0.0643).Conclusion: The procalcitonin level can predict the initiation of antibiotics, duration of antibiotics, multi-organ failure, and mortality in patients with acute pancreatitis.Keywords: procalcitonin, pancreatitis, acute pancreatitis

Keywords

• procalcitonin
• pancreatitis
• acute pancreatitis