Estimating the diagnostic accuracy of procalcitonin as a marker of the severity of acute pancreatitis: a meta-analytic approach.

CONTEXT Approximately 15-20% of cases of acute pancreatitis are categorized as severe. There is a lack of accurate predictors of disease severity. Several studies have evaluated the usefulness of procalcitonin as a marker of severe disease. Reports regarding the diagnostic accuracy of procalcitonin are conflicting. OBJECTIVE The present meta-analysis was carried out to evaluate the relevance of procalcitonin as a predictor of disease severity. METHODS Two investigators working independently attempted to locate eligible studies by electronic and manual means. Studies in which at least one of the markers of disease severity was procalcitonin were included for analysis. For all the studies included, the following parameters were calculated: true positive, false negative, false positive and true negative. A summary receiver operating characteristic (SROC) curve was generated from these parameters. RESULTS Four studies were finally included in the analysis. The unweighted regression line parameters b and i were 3.633 and 1.399, respectively. The values for b and i for weighted regression line were 3.637 and 1.428. The SROC curve generated demonstrated that procalcitonin is not a good predictor of the severity of acute pancreatitis. CONCLUSION The available data indicates that procalcitonin cannot be considered a good marker for assessing the severity of pancreatitis.