Značaj inflamatornih markera i poremećaja sistema hemostaze kod bolesnika sa akutnim pankreatitisom

Abstract

A possibility to develop sever systemic complications of acute pancreatitis(AP) demands timely assessment of the severity of the disease in order to make an optimal therapeutic approach and a correct prognosis of the disease. The aim of the study was to establish the role of certain individual inflammatory biomarkers and coagulation parameters in the prediction of AP severity, and also to propose a mathematical formula which allows there combined use for the same purpose. Methods. The prospective study included 92 patients with AP. The patients were divided into groups: mild, moderate and severe AP. Results. Based on the results of Mann-Whitney,s test, it can be concluded that a statistically significant difference between groups A(mild) and B(moderate and severe) for CRP (p<0.05). Using the Wald’s stepwise forward method, a prediction model with CRP, PCT, D-dimer 1, D-dimer 3, fibrinogen 1 and fibrinogen 3 parameters as predictors of the severity of AP has been obtained. The percentage of successful prediction of moderate or severe AP based on this model is 76.9%. Conclusion. The combined analysis of biohumoral markers and coagulation parameters presented in the form a mathematical formula can enable a more accurate, rapid, rational and clinically available prediction of the severity of AP.