Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://gr.elmerpub.com

Original Article

Volume 18, Number 2, April 2025, pages 56-62

Procalcitonin as a Predictor of Mortality in Patients With Severe Acute Pancreatitis

**Table 1.** Patient Characteristics and Main Clinical Data
	Total, n (%)	Survivors, n (%)	Non-survivors, n (%)	P value
^aChi-square test. ^bStudent’s t-test. APACHE: Acute Physiology and Chronic Health Evaluation; BISAP: Bedside Index for Severity in Acute Pancreatitis; n: number.
Number of patients	59	43 (72.9)	16 (27.1)
Sex				0.292^a
Men	34 (57.6)	23 (53.5)	11 (68.8)
Women	25 (42.4)	20 (46.5)	5 (31.2)
Etiology
Lithiasis	28 (47.5)	19 (44.1)	9 (56.3)	0.409^a
Endoscopic retrograde cholangiopancreatography	9 (15.3)	6 (14)	3 (18.8)	0.649^a
Idiopathic	7 (11.9)	6 (14)	1 (6.3)	0.416^a
Alcohol	6 (10.2)	5 (11.6)	1 (6.3)	0.543^a
Drugs	5 (8.5)	4 (9.3)	1 (6.3)	0.708^a
Hypertriglyceridemia	4 (6.8)	3 (7)	1 (6.3)	0.921^a
Balthazar
B	3 (5.1)	2 (4.7)	1 (6.3)	0.804^a
C	10 (16.9)	7 (16.3)	3 (18.8)	0.822^a
D	20 (33.9)	15 (34.9)	5 (31.2)	0.793^a
E	26 (44.1)	19 (44.1)	7 (43.8)	0.976^a
BISAP	1.86 ± 1.22	1.51 ± 1.03	2.81 ± 1.22	< 0.001^b
APACHE II	13.40 ± 6.42	12.23 ± 6.06	16.56 ± 6.48	0.020^b

Table 1. Patient Characteristics and Main Clinical Data

Total, n (%)

Survivors, n (%)

Non-survivors, n (%)

P value

^aChi-square test. ^bStudent’s t-test. APACHE: Acute Physiology and Chronic Health Evaluation; BISAP: Bedside Index for Severity in Acute Pancreatitis; n: number.

Number of patients

43 (72.9)

16 (27.1)

Sex

0.292^a

Men

34 (57.6)

23 (53.5)

11 (68.8)

Women

25 (42.4)

20 (46.5)

5 (31.2)

Etiology

Lithiasis

28 (47.5)

19 (44.1)

9 (56.3)

0.409^a

Endoscopic retrograde cholangiopancreatography

9 (15.3)

6 (14)

3 (18.8)

0.649^a

Idiopathic

7 (11.9)

6 (14)

1 (6.3)

0.416^a

Alcohol

6 (10.2)

5 (11.6)

1 (6.3)

0.543^a

Drugs

5 (8.5)

4 (9.3)

1 (6.3)

0.708^a

Hypertriglyceridemia

4 (6.8)

3 (7)

1 (6.3)

0.921^a

Balthazar

3 (5.1)

2 (4.7)

1 (6.3)

0.804^a

10 (16.9)

7 (16.3)

3 (18.8)

0.822^a

20 (33.9)

15 (34.9)

5 (31.2)

0.793^a

26 (44.1)

19 (44.1)

7 (43.8)

0.976^a

BISAP

1.86 ± 1.22

1.51 ± 1.03

2.81 ± 1.22

< 0.001^b

APACHE II

13.40 ± 6.42

12.23 ± 6.06

16.56 ± 6.48

0.020^b

**Table 2.** PCT Levels in Survivor Versus Non-Survivor Group
Hospitalization time	Mean ± SD	Median (IQR)	Mean rank	z	P value
^aMann-Whitney U test. IQR: interquartile range; n: number; PCT: procalcitonin; SD: standard deviation.
24 h
Survivors (n = 43)	3.72 ± 8.22	0.79 (0.25 - 1.79)	26.93	-2.251	0.024^a
Non-survivors (n = 16)	6.76 ± 7.66	3.12 (0.76 - 12.16)	38.25
72 h
Survivors (n = 43)	3.97 ± 9.48	0.82 (0.26 - 1.84)	25.98	-2.952	0.003^a
Non-survivors (n = 16)	8.60 ± 13.83	5.10 (0.94 - 9.16)	40.81

Table 2. PCT Levels in Survivor Versus Non-Survivor Group

Hospitalization time

Mean ± SD

Median (IQR)

Mean rank

P value

^aMann-Whitney U test. IQR: interquartile range; n: number; PCT: procalcitonin; SD: standard deviation.

24 h

Survivors (n = 43)

3.72 ± 8.22

0.79 (0.25 - 1.79)

26.93

-2.251

0.024^a

Non-survivors (n = 16)

6.76 ± 7.66

3.12 (0.76 - 12.16)

38.25

72 h

Survivors (n = 43)

3.97 ± 9.48

0.82 (0.26 - 1.84)

25.98

-2.952

0.003^a

Non-survivors (n = 16)

8.60 ± 13.83

5.10 (0.94 - 9.16)

40.81

**Table 3.** Correlation of PCT With Mortality
Mortality	PCT at 24 h	PCT at 72 h
^aSpearman’s correlation. PCT: procalcitonin; n: number.
Rho	0.346	0.428
P^a	0.006^a	0.005^a
N	59	59

Table 3. Correlation of PCT With Mortality

Mortality

PCT at 24 h

PCT at 72 h

^aSpearman’s correlation. PCT: procalcitonin; n: number.

Rho

0.346

0.428

P^a

0.006^a

0.005^a

**Table 4.** APACHE II, BISAP and Balthazar Scales Analysis With Mortality
Scales	AUC ROC	P value	95% CI	Cut-off point	Sensitivity	Specificity	PPV	NPV
*Significant. APACHE: Acute Physiology and Chronic Health Evaluation; AUC: area under the curve; BISAP: Bedside Index for Severity in Acute Pancreatitis; CI: confidence interval; NPV: negative predictive value; PPV: positive predictive value; ROC: receiver operating characteristic.
APACHE II	0.702 ± 0.07	0.018*	0.54 - 0.85	14.5	68%	67%	0.44	0.85
BISAP	0.783 ± 0.06	0.001*	0.64 - 0.91	1.5	81%	55%	0.40	0.88
Balthazar	0.486 ± 0.08	0.871	0.31 - 0.65	3.5	43%	55%	0.26	0.72

Table 4. APACHE II, BISAP and Balthazar Scales Analysis With Mortality

Scales

AUC ROC

P value

95% CI

Cut-off point

Sensitivity

Specificity

PPV

NPV

*Significant. APACHE: Acute Physiology and Chronic Health Evaluation; AUC: area under the curve; BISAP: Bedside Index for Severity in Acute Pancreatitis; CI: confidence interval; NPV: negative predictive value; PPV: positive predictive value; ROC: receiver operating characteristic.

APACHE II

0.702 ± 0.07

0.018*

0.54 - 0.85

14.5

68%

67%

0.44

0.85

BISAP

0.783 ± 0.06

0.001*

0.64 - 0.91

1.5

81%

55%

0.40

0.88

Balthazar

0.486 ± 0.08

0.871

0.31 - 0.65

3.5

43%

55%

0.26

0.72

**Table 5.** Levels of PCT Compared With the Mortality at Different Times
Hospitalization time	AUC ROC	P value	Cut-off point	Sensitivity	Specificity	PPV	NPV
AUC: area under the curve; NPV: negative predictive value; PCT: procalcitonin; PPV: positive predictive value; ROC: receiver operating characteristic.
24 h	0.692 ± 0.07	0.024	1.09	62%	65%	0.40	0.82
72 h	0.751 ± 0.06	0.003	1.26	75%	68%	0.46	0.87

Table 5. Levels of PCT Compared With the Mortality at Different Times

Hospitalization time

AUC ROC

P value

Cut-off point

Sensitivity

Specificity

PPV

NPV

AUC: area under the curve; NPV: negative predictive value; PCT: procalcitonin; PPV: positive predictive value; ROC: receiver operating characteristic.

24 h

0.692 ± 0.07

0.024

1.09

62%

65%

0.40

0.82

72 h

0.751 ± 0.06

0.003

1.26

75%

68%

0.46

0.87