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IL-6 and CRP are superior in early differentiation between mild and non-mild acute pancreatitis

Sternby, Hanna LU ; Hartman, Hannes LU ; Johansen, Dorthe LU ; Thorlacius, Henrik LU and Regnér, Sara LU (2017) In Pancreatology 17(4). p.550-554
Abstract

Background The revised Atlanta classification on acute pancreatitis (AP) presents distinct criteria for severity categorization. Due to the lack of reliable prognostic markers, a majority of patients with AP are currently hospitalized and initially managed identically. As incidence and financial costs are rising the need for early severity differentiation will increase. This study aimed to investigate the capacity of biomarkers to stratify AP patients during the initial course of the disease. Methods Patients with AP were prospectively enrolled and dichotomized into mild or non-mild (moderately severe and severe AP) according to the revised Atlanta classification. Serum samples taken within 13–36 h after onset of disease were analyzed... (More)

Background The revised Atlanta classification on acute pancreatitis (AP) presents distinct criteria for severity categorization. Due to the lack of reliable prognostic markers, a majority of patients with AP are currently hospitalized and initially managed identically. As incidence and financial costs are rising the need for early severity differentiation will increase. This study aimed to investigate the capacity of biomarkers to stratify AP patients during the initial course of the disease. Methods Patients with AP were prospectively enrolled and dichotomized into mild or non-mild (moderately severe and severe AP) according to the revised Atlanta classification. Serum samples taken within 13–36 h after onset of disease were analyzed for 20 biomarkers. Through receiver operating curves cut-off levels were set for 5 biomarkers whose stratifying ability was further analyzed. Additionally, the patients were classified according to the harmless acute pancreatitis score (HAPS). Results Among the 175 patients, 70.9% had mild and 29.1% non-mild AP. CRP and IL-6 combined, with cut-off levels 57.0 and 23.6 respectively, demonstrated superior discriminative capacity with an area under the curve of 0.803, sensitivity 98%, specificity 54% and a positive and negative likelihood ratio of 2.1 and 0.06 for the non-mild group. Regarding the mild group likelihood ratios were positive 26.5 and negative 0.48. The identification potential of the HAPS was generally inferior when compared to CRP plus IL-6. Conclusions In this study CRP and IL-6 demonstrate a clinically relevant capacity to differentiate mild from non-mild AP early in the course of AP.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute pancreatitis, Biomarkers, Classification, Stratification
in
Pancreatology
volume
17
issue
4
pages
5 pages
publisher
Karger
external identifiers
  • scopus:85020404782
  • wos:000406992000008
ISSN
1424-3903
DOI
10.1016/j.pan.2017.05.392
language
English
LU publication?
yes
id
f0080a31-a8ac-4479-8c92-8de5f7a98173
date added to LUP
2017-08-21 14:16:23
date last changed
2017-09-18 11:42:23
@article{f0080a31-a8ac-4479-8c92-8de5f7a98173,
  abstract     = {<p>Background The revised Atlanta classification on acute pancreatitis (AP) presents distinct criteria for severity categorization. Due to the lack of reliable prognostic markers, a majority of patients with AP are currently hospitalized and initially managed identically. As incidence and financial costs are rising the need for early severity differentiation will increase. This study aimed to investigate the capacity of biomarkers to stratify AP patients during the initial course of the disease. Methods Patients with AP were prospectively enrolled and dichotomized into mild or non-mild (moderately severe and severe AP) according to the revised Atlanta classification. Serum samples taken within 13–36 h after onset of disease were analyzed for 20 biomarkers. Through receiver operating curves cut-off levels were set for 5 biomarkers whose stratifying ability was further analyzed. Additionally, the patients were classified according to the harmless acute pancreatitis score (HAPS). Results Among the 175 patients, 70.9% had mild and 29.1% non-mild AP. CRP and IL-6 combined, with cut-off levels 57.0 and 23.6 respectively, demonstrated superior discriminative capacity with an area under the curve of 0.803, sensitivity 98%, specificity 54% and a positive and negative likelihood ratio of 2.1 and 0.06 for the non-mild group. Regarding the mild group likelihood ratios were positive 26.5 and negative 0.48. The identification potential of the HAPS was generally inferior when compared to CRP plus IL-6. Conclusions In this study CRP and IL-6 demonstrate a clinically relevant capacity to differentiate mild from non-mild AP early in the course of AP.</p>},
  author       = {Sternby, Hanna and Hartman, Hannes and Johansen, Dorthe and Thorlacius, Henrik and Regnér, Sara},
  issn         = {1424-3903},
  keyword      = {Acute pancreatitis,Biomarkers,Classification,Stratification},
  language     = {eng},
  month        = {07},
  number       = {4},
  pages        = {550--554},
  publisher    = {Karger},
  series       = {Pancreatology},
  title        = {IL-6 and CRP are superior in early differentiation between mild and non-mild acute pancreatitis},
  url          = {http://dx.doi.org/10.1016/j.pan.2017.05.392},
  volume       = {17},
  year         = {2017},
}