A Study on C-Reactive Protein as an Inflammatory Marker in Comparison with CT Severity Index of Balthazar in Predicting Severity of Acute Pancreatitis

Basil Mathew1, Rajagopalan G2*, Sabu S Jeyasekharan3 and Bala Vidyasagar3

1Department of Urology, Stanley Medical College, Chennai, India
2Department of Surgery, Jawaharlal Institute of Post Graduate Medical Education and Research, India
3Department of Surgery, Dr. Jeyasekharan Hospital and Nursing Home, India

^*Correspondance to: Rajagopalan G 

 PDF  Full Text DOI: 10.25107/2474-1647.2845

Abstract

Introduction: To determine relation between the C-reactive protein and acute pancreatitis, and to estimate the prognostic value of C-reactive protein in early Prediction of severity of acute pancreatitis. Material and Methods: During 2013-14, 90 patients with acute pancreatitis were included in the study. The clinical data, diagnostic procedures, and laboratory values were analyzed. C-reactive protein concentration in serum was measured on day 1, 2, and 3 after admission and a CT scan was done 72 h after admission. According to CT severity grading, patients were divided into three groups. Group I which is mild pancreatitis consisted of 32 patients, group II which is moderate pancreatitis consisted of 42 patients and group III which is severe pancreatitis consisted of 16 patients. The presence of correlation if any, between elevated levels of C-reactive protein and severity of acute pancreatitis in each group was analyzed by Spearman’s test and was found to be significantly correlating with a p value <0.05 on day 3 CRP in patients with severe disease. The sensitivity, specificity, positive and negative predictive values for different C-reactive protein concentration cut-off (100 mg/l to 170 mg/l) were calculated. Result: The highest C-reactive protein values were detected on day 3 in all groups. There was significant correlation between severe pancreatitis and day 3 CRP with a p value <0.05. The highest sensitivity and negative predictive value (85.71% and 89.04%) was obtained for C-reactive protein cut-off at 150 mg/L. Conclusion: The results of our study show that C-reactive protein values increase significantly in early stages of acute pancreatitis and it is an important prognostic marker of severe pancreatitis with pancreatic necrosis. The highest sensitivity and negative predictive value for CRP is 150 mg/L in severe pancreatitis. The patients with C-reactive protein below 150 mg/l are at low risk to develop severe pancreatitis with pancreatic necrosis.

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Mathew B, Rajagopalan G, Jeyasekharan SS, Vidyasagar B. A Study on C-Reactive Protein as an Inflammatory Marker in Comparison with CT Severity Index of Balthazar in Predicting Severity of Acute Pancreatitis. Clin Surg. 2020; 5: 2845..