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Pancreatic stone protein predicts outcome in patients with peritonitis in the ICU


Gukasjan, Raphael; Raptis, Dimitri Aristotle; Schulz, Hans-Ulrich; Halangk, Walter; Graf, Rolf (2013). Pancreatic stone protein predicts outcome in patients with peritonitis in the ICU. Critical Care Medicine, 41(4):1027-1036.

Abstract

OBJECTIVE: To determine the value of pancreatic stone protein in predicting sepsis-related postoperative complications and death in the ICU. DESIGN: A prospective cohort study of postoperative patients admitted to the ICU. Blood samples for analysis were taken within 3 hours from admission to the ICU including pancreatic stone protein, white blood cell counts, C-reactive protein, interleukin-6, and procalcitonin. The Mannheim Peritonitis Index and Acute Physiology and Chronic Health Evaluation II clinical scores were also determined. Univariate and multivariate analyses were performed to determine the diagnostic accuracy and independent predictors of death in the ICU [Clinicaltrials.gov, NCT01465711]. SETTING: An adult medical-surgical ICU in a teaching hospital in Germany. PATIENTS: Ninety-one consecutive postoperative patients with proven diagnosis of secondary peritonitis admitted to the ICU were included in the study from August 17, 2007, to February 8, 2010. INTERVENTIONS: Peripheral vein blood sampling. MEASUREMENTS AND MAIN RESULTS: Univariate analysis demonstrated that pancreatic stone protein has the highest diagnostic accuracy for complications and is the best predictor for death in the ICU. Pancreatic stone protein had the highest overall efficacy in predicting death with an odds ratio of 4.0 vs. procalcitonin (odds ratio 3.2), interleukin-6 (odds ratio 2.8), C-reactive protein (odds ratio 1.3), and WBCs (odds ratio 1.4). By multivariate analysis, pancreatic stone protein was the only independent predictor of death. CONCLUSIONS: In a population of patients with sepsis-related complications, serum-pancreatic stone protein levels demonstrate a high diagnostic accuracy to discriminate the severity of peritonitis and to predict death in the ICU. This test could be of value in the clinical diagnosis and therapeutic decision making in the ICU.

Abstract

OBJECTIVE: To determine the value of pancreatic stone protein in predicting sepsis-related postoperative complications and death in the ICU. DESIGN: A prospective cohort study of postoperative patients admitted to the ICU. Blood samples for analysis were taken within 3 hours from admission to the ICU including pancreatic stone protein, white blood cell counts, C-reactive protein, interleukin-6, and procalcitonin. The Mannheim Peritonitis Index and Acute Physiology and Chronic Health Evaluation II clinical scores were also determined. Univariate and multivariate analyses were performed to determine the diagnostic accuracy and independent predictors of death in the ICU [Clinicaltrials.gov, NCT01465711]. SETTING: An adult medical-surgical ICU in a teaching hospital in Germany. PATIENTS: Ninety-one consecutive postoperative patients with proven diagnosis of secondary peritonitis admitted to the ICU were included in the study from August 17, 2007, to February 8, 2010. INTERVENTIONS: Peripheral vein blood sampling. MEASUREMENTS AND MAIN RESULTS: Univariate analysis demonstrated that pancreatic stone protein has the highest diagnostic accuracy for complications and is the best predictor for death in the ICU. Pancreatic stone protein had the highest overall efficacy in predicting death with an odds ratio of 4.0 vs. procalcitonin (odds ratio 3.2), interleukin-6 (odds ratio 2.8), C-reactive protein (odds ratio 1.3), and WBCs (odds ratio 1.4). By multivariate analysis, pancreatic stone protein was the only independent predictor of death. CONCLUSIONS: In a population of patients with sepsis-related complications, serum-pancreatic stone protein levels demonstrate a high diagnostic accuracy to discriminate the severity of peritonitis and to predict death in the ICU. This test could be of value in the clinical diagnosis and therapeutic decision making in the ICU.

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12 citations in Web of Science®
13 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Visceral and Transplantation Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:08 Nov 2013 09:24
Last Modified:07 Dec 2017 23:31
Publisher:Lippincott, Williams & Wilkins
ISSN:0090-3493
Publisher DOI:https://doi.org/10.1097/CCM.0b013e3182771193
PubMed ID:23399938

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