Persistently High Procalcitonin and C-Reactive Protein Are Good Predictors of Infection in Acute Necrotizing Pancreatitis: A Systematic Review and Meta-Analysis

Tarján, Dorottya [Tarján, Dorottya (Orvosi tudományok), author] Institute for Translational Medicine (UP / UPMS); Centre for Translational Medicine (SU / KSZE); Institute of Pancreatic Diseases (SU / FM / C); Szalai, Eszter [Szalai, Eszter (Konzerváló fogászat), author] Centre for Translational Medicine (SU / KSZE); Helyreállító Fogászati és Endodonciai Klinika (SU / FD); Lipp, Mónika [Lipp, Mónika Bernadett (Gasztroenterológia), author] Centre for Translational Medicine (SU / KSZE); Institute of Pancreatic Diseases (SU / FM / C); Verbói, Máté; Kói, Tamás [Kói, Tamás (információelmélet), author] Department of Stochastics (BUTE / FNS / IM); Centre for Translational Medicine (SU / KSZE); Erőss, Bálint [Erőss, Bálint Mihály (Gasztroenterológia), author] Institute for Translational Medicine (UP / UPMS); Centre for Translational Medicine (SU / KSZE); Institute of Pancreatic Diseases (SU / FM / C); Teutsch, Brigitta [Teutsch, Brigitta (Gasztroenterológia), author] Institute for Translational Medicine (UP / UPMS); Radiológia Tanszék (SU / FM / C / OKK); Centre for Translational Medicine (SU / KSZE); Faluhelyi, Nándor [Faluhelyi, Nándor (Neurohumorális sz...), author] Department of Medical Imaging (UP / UPMS); Centre for Translational Medicine (SU / KSZE); Hegyi, Péter** ✉ [Hegyi, Péter (Gasztroenterológia), author] Institute for Translational Medicine (UP / UPMS); Centre for Translational Medicine (SU / KSZE); Institute of Pancreatic Diseases (SU / FM / C); Mikó, Alexandra [Mikó, Alexandra (Gasztroenterológia), author] Department of Medical Genetics (UP / UPMS); Institute for Translational Medicine (UP / UPMS); Centre for Translational Medicine (SU / KSZE)

English Survey paper (Journal Article) Scientific
Published: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES 1661-6596 1422-0067 25 (2) Paper: 1273 , 14 p. 2024
  • SJR Scopus - Inorganic Chemistry: D1
Identifiers
Fundings:
  • (TKP2021-EGA-23) Funder: Ministry for Innovation and Technology
  • (RRF-2.3.1-21-2022-00011)
  • (K131996)
  • (K147265)
  • (FK131864)
  • (UNKP-22-5)
  • (ÚNKP-22-3)
Subjects:
  • Meta-analysis
Infected necrotizing pancreatitis (INP) is associated with an increased risk of organ failure and mortality. Its early recognition and timely initiation of antibiotic therapy can save patients’ lives. We systematically searched three databases on 27 October 2022. In the eligible studies, the presence of infection in necrotizing pancreatitis was confirmed via a reference test, which involved either the identification of gas within the necrotic collection through computed tomography imaging or the examination of collected samples, which yielded positive results in Gram staining or culture. Laboratory biomarkers compared between sterile necrotizing pancreatitis and INP were used as the index test, and our outcome measures included sensitivity, specificity, the receiver operating characteristic (ROC) curve and area under the ROC curve (AUC). Within the first 72 hours (h) after admission, the AUC of C-reactive protein (CRP) was 0.69 (confidence interval (CI): 0.62–0.76), for procalcitonin (PCT), it was 0.69 (CI: 0.60–0.78), and for white blood cell count, it was 0.61 (CI: 0.47–0.75). After the first 72 h, the pooled AUC of CRP showed an elevated level of 0.88 (CI: 0.75–1.00), and for PCT, it was 0.86 (CI: 0.60–1.11). The predictive value of CRP and PCT for infection is poor within 72 h after hospital admission but seems good after the first 72 h. Based on these results, infection is likely in case of persistently high CRP and PCT, and antibiotic initiation may be recommended.
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2025-04-01 23:37