Circulating Cell-free DNA in Patients with Acute Biliary Pancreatitis: Association with Disease Markers and Prolonged Hospitalization Time-A Prospective Cohort Study.

Objective To evaluate cfDNA as an indicator of pancreatitis severity. Background Acute pancreatitis severity scores have limited proficiency, and are complex and challenging to use clinically. Elevation of circulating cell-free DNA (cfDNA) concentration has been shown to be associated to hospital length of stay (LOS) and mortality. Methods In a prospective study, cfDNA concentration was measured by a simple fluorometric test, at admission and for two consecutive days, in patients with acute biliary pancreatitis (ABP). Ranson and APACHE II scores were used as measures of pancreatitis severity. Hospital LOS and mortality were used as outcome measures. Results 78 patients were included. Patients with severe disease according to Ranson's Criteria (n = 24) had elevated median admission cfDNA compared to patients with mild disease (n = 54, 2252 ng/ml vs 1228 ng/ml, p 850 ng/ml) had a significantly longer LOS compared to those with normal cfDNA levels (p Conclusions cfDNA, measured by a rapid simple assay, proved a valuable early marker of severity in ABP with clear advantages for prediction of LOS over Ranson and APACHE II. Measurement of cfDNA has the potential to be an effective practical approach to predict the course of ABP and should be further evaluated in larger trials.