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Procalcitonin as a Decision‑Supporting Marker of Urgent Biliary Decompression in Acute Cholangitis

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Author(s)
조광범박경식이주엽이유진
Alternative Author(s)
Cho, Kwang BumPark, Kyung SikLee, Ju YupLee, Yoo Jin
Issued Date
2018
Keyword
CholangitisDrainageProcalcitoninSeverityPrediction
Abstract
Abstract
Background and Aim
This study aimed to evaluate the association of serum procalcitonin (PCT) at hospital presentation with disease severity and clinical deterioration to septic shock in acute cholangitis.

Methods
This study included consecutive patients with a diagnosis of acute cholangitis who presented to the emergency department and underwent biliary drainage. PCT and blood culture tests were conducted at the time of initial presentation. Patients were categorized into three groups based on disease severity. White blood cell count, levels of C-reactive protein and PCT were compared regarding the following: cholangitis severity, blood culture positivity, and clinical deterioration to septic shock.

Results
A total of 204 consecutive patients were enrolled, with grade I severity in 39 (19.1%), grade II in 139 (68.1%), and grade III in 26 (12.7%). The numbers of patients with blood culture positivity and clinical deterioration were 6 (15.4%) and 1 (2.6%) in grade I, 45 (32.4%) and 4 (2.9%) in grade II, and 14 (53.8%) and 1 (5.6%) in grade III cholangitis, respectively. Only PCT was significantly associated with blood culture positivity (3.25 vs 0.62 ng/mL; P = 0.001) and clinical deterioration (9.11 vs 0.89 ng/mL; P = 0.040). The cutoff value of PCT for clinical deterioration to septic shock among patients with grade I and II was 3.77 ng/mL (sensitivity of 80.0% and specificity of 74.0%).

Conclusion
PCT could be a promising marker of clinical deterioration to septic shock in acute cholangitis. Therefore, PCT might be used as a decision-supporting biomarker for urgent biliary decompression.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine (의과대학)
Citation
Dig Dis Sci., Vol.63(9) : 2474-2479, 2018
Type
Article
ISSN
1573-2568
DOI
10.1007/s10620-018-4963-1
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/41694
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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