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Serum Procalcitonin as a Potential Early Predictor of Short-Term Outcomes in Acute Severe Ulcerative Colitis

  • Hui-min Wu
  • Juan Wei
  • Jin Li
  • Kai Wang
  • Lei Ye
  • Ying Qi
  • Bo-si Yuan
  • Yu-lin Yang
  • Li Zhao
  • Zhao Yang
  • Miao-fang Yang
  • Jian-feng Gong
  • Fang-yu WangEmail author
Original Article

Abstract

Background

Delayed colectomy can be life-threatening for patients with acute severe ulcerative colitis (ASUC). However, few biomarkers can predict the outcomes of ASUC patients before treatment. Serum procalcitonin (PCT) has been observed to be increased in ASUC patients.

Aim

The aim of this study was to estimate the association between serum PCT and short-term outcomes in patients with ASUC.

Methods

A single-center observational study was conducted at a referral hospital from January 2012 to January 2018. Hospitalized ASUC patients, who were administered intravenous corticosteroids (IVCS), were enrolled and followed up for 6 months. The primary outcome was IVCS failure; the secondary outcome was colectomy. Relationships between indicators and clinical outcomes were assessed.

Results

Of 152 ASUC patients enrolled in this study, 81 responded to IVCS and 71 failed (62 required short-term colectomy and 9 responded to second-line rescue therapy). Serum PCT on admission was significantly higher in IVCS-failure cases and surgical cases than in medical responders. Serum PCT ≥ 0.10 µg/L (OR = 4.134, p = 0.001) predicted IVCS failure with specificity of 0.741, and the combined measurement with fecal calprotectin (FC) ≥ 1500 µg/g improved the sensitivity. Serum PCT correlated significantly with the Ulcerative Colitis Endoscopic Index of Severity (r = 0.416, p < 0.001) and FC (r = 0.384, p < 0.001).

Conclusion

Serum PCT on admission could be a potential early non-invasive predictive biomarker for IVCS failure in ASUC patients, and a combination of PCT and FC could improve the predictive value.

Keywords

Biomarker Procalcitonin (PCT) Acute severe ulcerative colitis (ASUC) Intravenous corticosteroids (IVCS) Colectomy Outcomes 

Abbreviations

Alb

Albumin

ASUC

Acute severe ulcerative colitis

CRP

C-reactive protein

ESR

Erythrocyte sedimentation rate

FC

Fecal calprotectin

Hb

Hemoglobin

IVCS

Intravenous corticosteroids

MODS

Multiple organ dysfunction syndrome

PCT

Procalcitonin

UCEIS

Ulcerative Colitis Endoscopic Index of Severity

Notes

Acknowledgments

We would like to thank Dr. Xiaowei Wu at Jinling Hospital for his critical reading of the manuscript.

Author's contribution

HW, JW, and FW contributed to the conception and design of this study. HW, JL, KW, BY, and LZ made substantial contributions to data acquisition. HW, KW, YQ, LY, and YY contributed to data analysis, data interpretation, and drafting of the manuscript. HW, ZY, MY, JG, and FW contributed to revision and proofreading of the manuscript. All authors had full access to all the data in the study and agreed with this submission.

Funding

This work was supported by the National Natural Science Foundation of China (Grant No. 81570506).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical consideration

This study complied with the principles of the Declaration of Helsinki. Patients were informed of the design of this study and were given the opportunity to refuse participation. The study was approved by the ethics committee of Jinling Hospital and was registered in ClinicalTrials.gov (NCT03578692).

Supplementary material

10620_2018_5446_MOESM1_ESM.pdf (583 kb)
Supplementary material 1 (PDF 583 kb)
10620_2018_5446_MOESM2_ESM.docx (30 kb)
Supplementary material 2 (DOCX 30 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Hui-min Wu
    • 1
  • Juan Wei
    • 2
  • Jin Li
    • 3
  • Kai Wang
    • 4
  • Lei Ye
    • 1
  • Ying Qi
    • 1
  • Bo-si Yuan
    • 1
  • Yu-lin Yang
    • 1
  • Li Zhao
    • 3
  • Zhao Yang
    • 1
  • Miao-fang Yang
    • 1
  • Jian-feng Gong
    • 4
  • Fang-yu Wang
    • 1
    • 2
    Email author
  1. 1.Department of Gastroenterology and Hepatology, Jinling HospitalMedical School of Nanjing UniversityNanjingChina
  2. 2.Department of Gastroenterology and HepatologyJinling Clinical Medical College of Nanjing Medical UniversityNanjingChina
  3. 3.Bengbu Medical CollegeBengbuChina
  4. 4.Department of General Surgery, Jinling HospitalMedical School of Nanjing UniversityNanjingChina

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