scholarly journals Study of BISAP Scoring System, Ranson’s Scoring System and C-Reactive Protein Level as Predictors of Clinical Outcome in Acute Pancreatitis

2021 ◽  
Vol 10 (11) ◽  
pp. 784-788
Author(s):  
Gaikwad Avinash Machindra ◽  
Rajeshwara K.V.

BACKGROUND This study was conducted to compare BISAP scoring system, Ranson’s score and CRP levels in predicting the clinical outcome in acute pancreatitis and for early detection of severity and organ failure in acute pancreatitis. METHODS This study was an observational longitudinal analytical study conducted among patients admitted with diagnosis of acute pancreatitis, in Father Muller Medical College Hospital, Mangalore, from November 2016 to March 2018. The study was started after obtaining ethical clearance from the institution’s ethical clearance committee. All patients diagnosed with acute pancreatitis between the age 20 and 60 years were included in the study. RESULTS Comparison of serum CRP levels between the Atlanta classified groups shows that severe group has the maximum value of 340.966 and mild has the minimum value of 55.38. This difference is statistically significant with a test value of 16.543 and a P value of < 0.001. On comparison of the test group, Ranson’s score with the BISAP score, the test group had a sensitivity of 89.3 % and specificity of 77.3 %. CONCLUSIONS The study has demonstrated the concordance between Ranson’s score, BISAP score and serum CRP level as predictors of clinical outcome in acute pancreatitis. KEY WORDS Acute Pancreatitis, Clinical Outcome, C Reactive Protein, Scoring Systems.

2019 ◽  
Vol 6 (9) ◽  
pp. 3328
Author(s):  
Juthika Abhijit Deherkar ◽  
Ayush Pandey ◽  
Shahaji Deshmukh

Background: Acute pancreatitis is one of the most common problems faced by surgeon in their practice. Alcohol being one of the most important etiology in country like India. The most common line of management has always been conservative until and unless surgery is indicated for its complications. Till date amylase and lipase have been used as diagnostic tool for it however certain prognostic tools like CRP are still under evaluation. Thus we have made an attempt to evaluate its significance as a prognostic tool in this study.Methods: A hospital based observational comparative prospective study was done with 100 patients to measure C-reactive protein (CRP) levels in patients of acute pancreatitis and evaluate if CRP levels predict the severity of pancreatitis.Results: The mean serum CRP level of patients with Ranson’s score <3 was significantly higher as compared to mean serum CRP level of patients with Ranson’s score ≥3 (10.54±5.00 mg/l vs 7.29±3.94 mg/l). There was significant association of serum CRP and Ranson’s score of patients.Conclusions: The rapid response of CRP to changes in the intensity of the inflammatory stimulus suggests that it might be valuable in the assessment and monitoring of acute pancreatitis. It was observed in our study that measurement of CRP level is a simple method to assess the severity of disease.


2021 ◽  
Vol 10 (35) ◽  
pp. 2985-2988
Author(s):  
Aditya Vasant Ghunage ◽  
Kiran Shrikant Kher

BACKGROUND Acute pancreatitis (AP) is a dormant deadly illness. The range of seriousness of the ailment goes from mellow self-restricting disease to an exceptionally lethal severe necrotizing pancreatitis. The disease has such a variable course that it may manifest as a simple pain in the abdomen to severe haemorrhagic pancreatitis with septicaemic shock, multi-organ dysfunction syndrome and ultimately leading to death. A cost-effective better prognosticative index is needed for the assessment of the severity of AP. Here in this study, we wanted to assess the role of BISAP scoring systems and CRP for analysis and comparing their values to determine the severity of AP and the prognosis of the disease. METHODS A prospective observational study was done on 83 patients diagnosed with AP after fulfilment of inclusion criteria. Patients were subjected to severity index, bedside index for severity in acute pancreatitis (BISAP) score and CRP calculation and statistical analysis was done with SPSS software. RESULTS In our study, AP was more prevalent in males 87.95 % than females 12.05 %. AP was found to be more common in cases ≤ 40 years of age, however, the mean age of presentation was 38.14 ± 12.59 years. We calculated the sensitivity and specificity of the BISAP score and C-reactive protein (CRP) by co-relating it with CT severity index as gold standard according to which the sensitivity was found to be 64 % and specificity was found to be 85 % for BISAP. The sensitivity and specificity of CRP was 64 % and 85 % respectively. CONCLUSIONS BISAP is an easy way to anticipate the severity of AP within 24 hours. It also helps to prognosticate AP. CRP can also be used to aid BISAP in the assessment of severe acute pancreatitis (SAP). KEY WORDS Acute Pancreatitis, BISAP, CRP.


2012 ◽  
Vol 10 (2) ◽  
pp. 91-99 ◽  
Author(s):  
Pamela McCall ◽  
Jamie Catlow ◽  
Peter A McArdle ◽  
Donald C McMillan ◽  
Joanne Edwards

i-Perception ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 204166952110099
Author(s):  
Ingrid Ekström ◽  
Davide Liborio Vetrano ◽  
Goran Papenberg ◽  
Erika J. Laukka

Importance Olfactory deficits are common in aging and associated with several conditions linked to inflammation. A few studies suggest that increased concentration of pro-inflammatory biomarkers may be related to olfactory deficits, but these associations are understudied in population-based samples. Objective To investigate the association between serum concentrations of C-reactive protein (CRP) and olfactory identification level as well as rate of change in aging. Methods We included 1,721 participants (mean age 70.5 years; 61.9% female) with at least two olfactory assessments across the 12-year follow-up. Baseline level and change in odor identification were estimated with linear mixed models as a function of CRP levels, derived from blood plasma at baseline. Results Results indicated a negative dose–response association between CRP level and odor identification scores at baseline, after adjustment for demographic, cognitive, health, and lifestyle factors. CRP levels ranging between 11 and 20 mg/L were significantly related to lower olfactory ability (β = −0.811, 95% confidence interval [CI] [−1.503 to −0.118]; p = .022). Likewise, CRP values above 20 mg/L were related to lower olfactory scores, an association that approached statistical significance (β = −0.996, 95% CI [−2.045 to 0.054]; p = .063). We found no associations between CRP and olfactory change ( ps > .368). Sensitivity analyses showed that associations between CRP and olfaction were confined to younger participants (age ≤72 years) and men ( ps < .034). Conclusions Our findings suggest a negative association between serum CRP levels and olfactory identification ability in aging that may be dependent on age and sex.


Author(s):  
Andriy Zhydkov ◽  
Mirjam Christ-Crain ◽  
Robert Thomann ◽  
Claus Hoess ◽  
Christoph Henzen ◽  
...  

AbstractThe added value of biomarkers, such as procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBC), as adjuncts to clinical risk scores for predicting the outcome of patients with community-acquired pneumonia (CAP) is in question. We investigated the prognostic accuracy of initial and follow-up levels of inflammatory biomarkers in predicting death and adverse clinical outcomes in a large and well-defined cohort of CAP patients.We measured PCT, CRP and WBC on days 1, 3, 5, and 7 and followed the patients over 30 days. We applied multivariate regression models and area under the curve (AUC) to investigate associations between these biomarkers, the clinical risk score CURB-65, and clinical outcomes [i.e., death and intensive care unit (ICU) admission].Of 925 patients with CAP, 50 patients died and 118 patients had an adverse clinical outcome. None of the initial biomarker levels significantly improved the CURB-65 score for mortality prediction. Follow-up biomarker levels showed significant independent association with mortality at days 3, 5, and 7 and with improvements in AUC. Initial PCT and CRP levels were independent prognostic predictors of adverse clinical outcome, and levels of all biomarkers during the course of disease provided additional prognostic information.This study provides robust insights into the added prognostic value of inflammatory markers in CAP. Procalcitonin, CRP, and to a lesser degree WBC provided some prognostic information on CAP outcomes, particularly when considering their kinetics at days 5 and 7 and when looking at adverse clinical outcomes instead of mortality alone.


Author(s):  
Doruk Akgün ◽  
Mats Wiethölter ◽  
Paul Siegert ◽  
Victor Danzinger ◽  
Marvin Minkus ◽  
...  

Abstract Introduction There is a paucity of literature regarding serum C-reactive protein (CRP) in the evaluation of a shoulder periprosthetic joint infection (PJI). The purpose of the current study was to establish cutoff values for diagnosing shoulder PJI and evaluate the influence of the type of infecting microorganism and the classification subgroups according to last proposed International Consensus Meeting (ICM) criteria on the CRP level. Materials and methods A retrospective analysis of all 136 patients, who underwent septic or aseptic revision shoulder arthroplasty in our institution between January 2010 and December 2019, was performed. Shoulder PJI was defined according to the last proposed definition criteria of the ICM. Serum CRP levels were compared between infected and non-infected cases, between infection subgroups, as well as between different species of infecting microorganisms. A receiver-operating characteristic (ROC) analysis was performed to display sensitivity and specificity of serum CRP level for shoulder PJI. Results A total of 52 patients (38%) were classified as infected, 18 meeting the criteria for definitive infection, 26 for probable infection and 8 for possible infection. According to the ROC curve, an optimized serum CRP threshold of 7.2 mg/l had a sensitivity of 69% and specificity of 74% (area under curve = 0.72). Patients with definitive infection group demonstrated significantly higher median serum CRP levels (24.3 mg/l), when compared to probable, possible infection groups and PJI unlikely group (8 mg/l, 8.3 mg/l, 3.6 mg/l, respectively, p < 0.05). The most common isolated microorganism was Cutibacterium acnes in 25 patients (48%) followed by coagulase-negative staphylococci (CNS) in 20 patients (39%). Patients with a PJI caused by high-virulent microorganisms had a significantly higher median serum CRP level compared to patients with PJI caused by low-virulent microorganisms (48 mg/l vs. 11.3 mg/l, p = 0.04). Conclusions Serum CRP showed a low sensitivity and specificity for the diagnosis of shoulder PJI, even applying cutoffs optimized by receiver-operating curve analysis. Low-virulent microorganisms and patients with probable and possible infections are associated with lower CRP levels compared to patients with definitive infection and infections caused by high-virulent microorganisms. Level of evidence Diagnostic Level III.


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