Role of Serum Procalcitonin as an Early Biomarker of Severity in Acute Pancreatitis: A Prospective Observational Study

Abstract

Background: Early prediction of severe acute pancreatitis (SAP) remains a clinical challenge despite the availability of several prognostic scoring systems. Serum procalcitonin (PCT), an inflammatory biomarker that rises rapidly during systemic inflammation and infection, has emerged as a promising predictor of disease severity. Early estimation of PCT may facilitate prompt identification of patients requiring intensive management.
Objective: To evaluate the role of serum procalcitonin as an early biomarker of severity in patients with acute pancreatitis and determine its association with Ranson score.
Materials and Methods: This prospective observational study was conducted from May 2022 to May 2024 in the Department of Biochemistry in collaboration with the Department of General Surgery at J.L.N. Medical College and Associated Hospitals, Ajmer. Adult patients diagnosed with acute pancreatitis according to the Revised Atlanta Classification were enrolled after obtaining informed consent. Serum procalcitonin was measured within 24 hours of admission using an immunoassay-based method. Disease severity was assessed using the Ranson scoring system and patients were categorized into mild, moderately severe, and severe acute pancreatitis. Statistical analysis was performed using SPSS version 26.0. Continuous variables were expressed as mean ± SD, and categorical variables as frequencies and percentages. Pearson correlation, one-way ANOVA, ROC curve analysis, and multivariable logistic regression were used where appropriate. A p-value <0.05 was considered statistically significant.
Results: Serum procalcitonin levels increased progressively with increasing severity of acute pancreatitis and demonstrated a significant positive correlation with Ranson score. ROC analysis showed excellent diagnostic performance for predicting severe acute pancreatitis. Elevated PCT was independently associated with persistent organ failure and severe disease.
Conclusion: Serum procalcitonin is a valuable early biomarker for predicting severe acute pancreatitis. Its routine assessment at admission may improve early risk stratification and clinical decision-making.