Can C-reactive protein levels increase the accuracy of the Ranson score in predicting the severity and prognosis of acute pancreatitis? A prospective cohort study

Başak, Fatih; Hasbahçeci, Mustafa; Şişik, Abdullah; Acar, Aylin; Tekeşin, Kemal; Baş, Gürhan; Ali̇moğlu, Orhan

doi:10.5152/tjg.2017.16686

Cited by 5 publications

(6 citation statements)

References 21 publications

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“…CRP and Ranson scores were correlated with mortality in our study. This finding is consistent with the findings of one of the studies conducted by Başak et al [23].…”

Section: Discussionsupporting

confidence: 94%

Novel markers for mortality in patients with acute pancreatitis: NLR and PLR at the 48th hour

Yalçın¹,

Yalakı²

2019

Journal of Surgery and Medicine

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In recent years, simple, effective, and rapid laboratory markers have become important to predict acute pancreatitis prognosis. In this study, we aimed to demonstrate whether there was a difference in predicting AP-related mortality between current scores and indirect markers of systemic inflammation, namely, red cell distribution width (RDW), mean platelet volume (MPV), plateletlymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) obtained at the 48 th hour. Methods: We retrospectively reviewed files of AP patients admitted to Gastroenterology Department of two hospitals to include the acute phase reactant values of 667 patients obtained at the 48 th hour. CRP0 indicates CRP value at presentation while CRP, RDW, MPV, NLR and PLR indicate values at the 48 th hour. In all patients, Ranson score, Atlanta score, NLR and PLR values were calculated. Results: The patients were classified into 2 groups as survivors (n=641; 96.1%) and non-survivors (n=26; 3.9%). Both NLR and PLR were found to be significantly higher in the non-survivor group (P<0.001 and P=0.02). Both NLR and PLR were weakly and positively correlated to mortality. Conclusion: Based on our results, MPV was not correlated with mortality, while RDW was weakly and positively correlated. However, we found that NLR and PLR values obtained at the 48 th hour after presentation are effective parameters in predicting mortality in AP. These easily accessible and low-cost tests may be used for closer monitoring of these patients when necessary.

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“…CRP and Ranson scores were correlated with mortality in our study. This finding is consistent with the findings of one of the studies conducted by Başak et al [23].…”

Section: Discussionsupporting

confidence: 94%

Novel markers for mortality in patients with acute pancreatitis: NLR and PLR at the 48th hour

Yalçın¹,

Yalakı²

2019

Journal of Surgery and Medicine

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“…They showed higher serum levels of IL-8 in patients with SAP compared with patients with mild or moderate AP, and established the highest sensitivity and diagnostic accuracy in predicting severity on the second day of hospitalization [32]. Başak et al [33] used Ranson score and CRP in predicting the severity of AP. They demonstrated that the concomitant use of CRP and Ranson score could distinguish SAP from mild AP, with the sensitivity, specificity, and accuracy of CRP of 82.9%, 80.9%, and 81.1%, respectively [33].…”

Section: Binomial Logistic Regressionmentioning

confidence: 99%

“…Başak et al [33] used Ranson score and CRP in predicting the severity of AP. They demonstrated that the concomitant use of CRP and Ranson score could distinguish SAP from mild AP, with the sensitivity, specificity, and accuracy of CRP of 82.9%, 80.9%, and 81.1%, respectively [33]. Vasseur et al [18] analyzed the role of IL-22 in AP course and showed a high increase during the early phase of AP.…”

Section: Binomial Logistic Regressionmentioning

confidence: 99%

Interleukins and inflammatory markers are useful in predicting the severity of acute pancreatitis

Ćeranić

Zorman

Skok

2019

Bosn J of Basic Med Sci

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Acute pancreatitis (AP) is a disease with significant morbidity and mortality. The aim of this study was to evaluate the prognostic role of inflammatory markers, particularly interleukins (ILs), in the course of AP and to determine the frequency of etiologic factors of AP. We included patients with AP who were treated at our institution from May 1, 2012 to January 31, 2015. Different laboratory parameters, including ILs, and the severity scoring systems Ranson’s criteria and Bedside Index of Severity in Acute Pancreatitis (BISAP) were analyzed. AP was classified into mild and severe, and independent parameters were compared between these groups. The predictive performance of each parameter was evaluated using receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC). A binomial logistic regression was performed to evaluate Ranson’s criteria and IL6, IL8, and IL10 (at admission and after 48 hours) in the course of AP. Overall, 96 patients were treated, 59 (61.5%) males and 37 (38.5%) females, average age 62.5 ± 16.8 years (range 22–91 years). The best predictor for the severity of AP was IL6, measured 48 hours after admission (AUC = 0.84). Other useful predictors of the severity of AP were lactate dehydrogenase (p < 0.001), serum glucose (p < 0.006), and difference in the platelet count (p < 0.001) between admission and after 48 hours (p < 0.001), hemoglobin (p < 0.027) and erythrocytes (p < 0.029). The major causes of AP were gallstones and alcohol consumption. According to our results, IL6 and Ranson score are important predictors of the severity of AP.

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“…However, all of these biomarkers and scoring systems have limits. For example, acute phase proteins, such as C-reactive protein (CRP), serum amyloid A protein (SAA), lipopolysaccharide-binding protein (LBP), and pentraxin 3 (PTX 3), are nondisease specific, whereas the scoring systems are unsuitable in clinical practice due to their complex and time-consuming [22][23][24]. In this study, we found the levels of sB7-H5 could identify SAP with good sensitivity and specificity.…”

Section: Discussionmentioning

confidence: 86%

Soluble B7-H5 Is a Novel Diagnostic, Severity, and Prognosis Marker in Acute Pancreatitis

Xu¹,

Gong

Chen³

et al. 2021

BioMed Research International

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As an important ligand in T lymphocyte costimulatory pathways, B7-H5 is involved deeply in the immune response in various diseases. However, its clinical usefulness as an early indicator in acute pancreatitis (AP) remains unclear. In this study, the levels of sB7-H5 and cytokines in plasma samples of 75 AP patients, 20 abdominal pain patients without AP, and 20 healthy volunteers were determined. Then, the correlation of sB7-H5 and clinical features, cytokines, the Ranson score, APACHE II score, Marshall score, and BISAP score was analysed, and the value of sB7-H5 for diagnostic, severity, and prognosis of AP was evaluated. We found that the levels of sB7-H5 were specifically upregulated in AP patients. Receiver operating characteristic (ROC) analysis revealed that sB7-H5 can identify AP patients from healthy or abdominal pain patients with 78.9% or 86.4% sensitivity and 93.3% or 90.0% specificity. Further analysis showed that the levels of sB7-H5 were significantly correlated with WBC ( p = 0.004 ), GLU ( p = 0.008 ), LDH ( p < 0.001 ), Ca2+ ( p = 0.006 ), AST ( p = 0.009 ), PLT ( p = 0.041 ), IL-6 ( p < 0.001 ), IL-10 ( p < 0.001 ), and TNF-α ( p < 0.001 ). And levels of sB7-H5 were gradually increased among patients with mildly acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP). It can distinguish the severity of AP with good sensitivity and specificity. Moreover, when dividing the patients into two groups according to the median level of sB7-H5, the local complication and length of stay of low levels of the sB7-H5 group were significantly less than those in high levels of the sB7-H5 group. And the levels of sB7-H5 in AP patients were significantly correlated with the Ranson score ( p < 0.001 ), APACHE II score ( p < 0.001 ), Marshall score ( p < 0.001 ), and BISAP score ( p < 0.001 ). The AUCs of assessing local complications of sB7-H5 at day 1 and day 3 were 0.704 ( p = 0.0024 ) and 0.727 ( p = 0.0373 ). These results showed the potential value of sB7-H5 as a diagnostic, severity, and prognosis marker of AP.

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Can C-reactive protein levels increase the accuracy of the Ranson score in predicting the severity and prognosis of acute pancreatitis? A prospective cohort study

Cited by 5 publications

References 21 publications

Novel markers for mortality in patients with acute pancreatitis: NLR and PLR at the 48th hour

Novel markers for mortality in patients with acute pancreatitis: NLR and PLR at the 48th hour

Interleukins and inflammatory markers are useful in predicting the severity of acute pancreatitis

Soluble B7-H5 Is a Novel Diagnostic, Severity, and Prognosis Marker in Acute Pancreatitis

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