C-reactive protein levels in acute pancreatitis and its clinical significance

Deherkar, Juthika Abhijit; Pandey, Ayush; Deshmukh, Shahaji

doi:10.18203/2349-2902.isj20194074

Cited by 9 publications

(7 citation statements)

References 7 publications

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“…Deherkar JA et al surveyed 100 patients with AP. The mean age of the study population in this group was 38.3 ± 12.92 years, which was analogous to the present study [7]. Like this, as studied by Sharma V et al, the age demography also depicted the mean age as 39.33 ± 13.85 years (range 13-75 years) [8].…”

Section: Discussionsupporting

confidence: 89%

Validity of the Adapted Waterlow Score as a Tool in Predicting Adverse Outcomes in Acute Pancreatitis When Compared With the Ranson Score and Serum CRP Levels

Prakash¹,

Soni²,

Tekwani³

2022

Cureus

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IntroductionAcute pancreatitis (AP) is one of the most common emergency room presentations, with an annual worldwide incidence of 150-420 cases per million and a 30-50% mortality rate. Unfortunately, predicting prognosis in AP patients at an early admission phase is difficult. The Waterlow score is a semi-quantitative composite score devised to stratify the risk of developing pressure sores in in-patient settings. Components such as age, gender, nutritional status, body mass index, mobility, smoking status, comorbidities, surgery, use of medications, neurological status, and continence, all combine to generate a single numerical figure between 2 and 64 to overcome the difficulty of the composite scoring systems such as the Ranson score, Glassgow score, Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and its modification (Portsmouth or P-POSSUM), Simplified Acute Physiology Score (SAPS 2), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Bedside index for severity in acute pancreatitis (BISAP). AimThis study aimed to validate the Waterlow score as a surrogate marker in predicting in-patient mortality, length of hospital stay (LOHS), intensive care unit (ICU) admissions, and AP complications compared to the Ranson score and serum CRP levels. MethodA prospective case series analysis was conducted from August 2018 to November 2019 at a tertiary care center in central Gujarat. This study included 51 newly diagnosed patients with AP or acute on chronic pancreatitis on accrual. Out of 51 patients, four were excluded from our study, as three were discharged against medical advice (DAMA) and one other absconded from the ward premises. The study group comprised 47 patients diagnosed with AP, out of which 40 patients were male (85.1%) and seven were females (14.9%). The mean age of the population was 37.5 ± 13.0 years. Microsoft Excel calculated the standard deviation and mean for data entry. All statistical analyses were made with MedCalc software version 19.1.3 (MedCalc Software Ltd., Ostend, Belgium).

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Section: Discussionsupporting

confidence: 89%

Validity of the Adapted Waterlow Score as a Tool in Predicting Adverse Outcomes in Acute Pancreatitis When Compared With the Ranson Score and Serum CRP Levels

Prakash¹,

Soni²,

Tekwani³

2022

Cureus

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“…3,4 The prevalence of acute pancreatitis has been projected to escalate with the growing prevalence of biliary diseases and alcoholism, which are the main etiological factors. 5,6 The extreme type prognosis is low, arises in 8.8 percent of AP, and can hit 28 percent of severe AP (SAP) mortality.1,7 Though, with systemic and local complications, roughly 15-20 percent of patients experience clinically serious AP. 8 For the early detection of patients at highest risk of acquiring clinically serious AP, a variety of laboratory and clinical prognostic scoring frameworks have been developed.…”

Section: Introductionmentioning

confidence: 99%

Correlation of C-Reactive Protein and Computed Tomography Severity Index in Acute Pancreatitis

Irshad¹,

Ahsan²,

Khan³

et al. 2021

Annals KEMU

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Background: Acute pancreatitis is the inflammatory disorder which can be mild or severe. Early diagnosis and proper assessment of the disease severity have a critical role in its treatment. Objective: Determine the correlation of C-reactive protein and computed tomography severity index in acute pancreatitis. Methods: This cross-sectional study took place at department of General surgery, Pakistan Institute of Medical Sciences hospital Islamabad (PIMS), from September 2019 to February 2020. Patients of age between 15-70 years, presenting with acute severe epigastrium pain spreading to back, diagnosed as acute pancreatitis by serum amylase of 1000 units or more and either gender were included. CT scan was performed within 24 hours following presentation using axial slices of dome in diaphragm up-to pelvis by IV contrast. Slice had 3 mm of thickness in pancreas region. Various parameters of pancreatic inflammatory response, ratio of pancreatic parenchymal necrosis and additional pancreatic complications are included in the updated CT severity index measured on CT, with various points given for each parameter. A score over 5 is rated as severe pancreatitis. A blood sample was taken from each patient for CRP level. A CRP level of >10 mg/L was considered as positive. All the information was recorded via self-prepared proforma. Data analysis was done by SPSS version 20. Results: Total 67 patients of acute pancreatitis were selected for this study. Out of them, 59.7% were males and remaining were females. Most common age group was 46-60 years 43.3%. According to the pancreatic grading most of the patients presented with grade C as 29.9% and grade B as 23.9%, followed by grade D 20.95, grade E14.9% and 10.45 were normal. According to the pancreatic necrosis majority of the cases 41.8% had < 30%. There was a strong positive correlation between CT severity index and CRP level, r-value 0.346. Conclusion: C reactive protein is a reliable and non-invasive diagnostic tool for acute pancreatitis and its severity, which showed strong positive correlation with CT severity index of acute pancreatitis.

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“…3,17 The previous studies by Komolafe et al, and Deherkar et al, have highlighted prognostic value of elevated CRP values in assessment during early stages of AP. 17,18 Stirling et al, suggested that rise of >90 mg/dL or value of >190 mg/dL at 48 h can prognosticate disease severity with greatest presion. 19 However, American College of Gastroenterology has issued guidelines suggesting that "no laboratory test, including CRP, is practically available or consistently accurate to predict severity in patients with AP" as CRP takes 72 h to become accurate to predict disease severity.…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein and modified computed tomography severity index in assessing severity of acute pancreatitis

Lahan¹,

Sonowal²,

Teli³

et al. 2023

Asian J Med Sci

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Background: The mortality and morbidity associated with acute pancreatitis (AP) demands timely management and prediction of disease progression and clinical outcome. Multifactorial scoring systems shall facilitate risk stratification and prognostic assessment in AP. Aims and Objectives: The aim of the study was (i) to assess C-reactive protein (CRP) levels and modified computed tomography severity index (mCTSI) in AP patients and their association with the clinical outcome and (ii) to determine the correlation between CRP levels and mCTSI scores in AP. Materials and Methods: This cross-sectional, hospital-based study comprised 90 patients diagnosed with AP. Data collection included sociodemographic information, clinical presentation, and CRP estimation. The mCTSI score was estimated by axial slices contrast-enhanced computed tomography of abdomen and was used to assess the severity of AP. Categorical data were analyzed by Chi-square test and Pearson’s coefficient was estimated to determine the correlation between CRP levels and mCTSI score. P<0.05 was adopted as level of significance. Results: The study comprised 81 males (90%) and 9 females (10%). The mean age of the patients was 36.94±9.19 years, with majority in age group of 31–40 years (40%). Alcohol consumption (>50 g/day) was the commonest risk factor in 82.22% (n=74) patients, followed by hypertriglyceridemia in 13.33% (n=12) patients. Pain in abdomen was the most common presentation in 96.67% (n=87) patients, followed by vomiting 57.78% (n=52) patients. Majority of patients [82.22% (n=74)] had CRP levels of 10–21 mg/dL. Mild, moderate, and severe mCTSI scores were obtained in 17.78%, 66.67%, and 15.55% patients, respectively. There is a significant positive correlation between CRP values and mCTSI scores with r=0.3008 (P=0.003). Conclusion: CRP level had significant positive correlation with mCTSI scores in AP. Higher values of CRP and severe mCTSI scores had worse clinical outcome in AP.

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C-reactive protein levels in acute pancreatitis and its clinical significance

Cited by 9 publications

References 7 publications

Validity of the Adapted Waterlow Score as a Tool in Predicting Adverse Outcomes in Acute Pancreatitis When Compared With the Ranson Score and Serum CRP Levels

Validity of the Adapted Waterlow Score as a Tool in Predicting Adverse Outcomes in Acute Pancreatitis When Compared With the Ranson Score and Serum CRP Levels

Correlation of C-Reactive Protein and Computed Tomography Severity Index in Acute Pancreatitis

C-reactive protein and modified computed tomography severity index in assessing severity of acute pancreatitis

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