Assessment of BISAP Scoring System and C-Reactive Protein Analysis in Predicting Severity of Acute Pancreatitis

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.

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Role of C-reactive protein in predicting the outcome of acute pancreatitis

International Surgery Journal ◽

10.18203/2349-2902.isj20215150 ◽

2021 ◽

Vol 9 (1) ◽

pp. 165

Author(s):

Venkatesh S. ◽

Neetha V. ◽

Manish S. ◽

Krishnan P. B.

Keyword(s):

Acute Pancreatitis ◽

Clinical Practice ◽

Scoring Systems ◽

C Reactive Protein ◽

Early Assessment ◽

Serum Lipase ◽

Protein Levels ◽

Reactive Protein ◽

Delayed Recovery

Background: Acute pancreatitis is one of the most commonly encountered clinical entities in surgical practice and controversy still exists regarding the clinical features of acute pancreatitis. An early diagnosis, however, is regarded as mandatory for successful treatment. Over the years many Authors have proposed different scoring systems for the early assessment of the clinical evolution of acute pancreatitis. The most widely used scoring systems are often cumbersome and difficult to use in clinical practice because of their multi factorial nature. Thus, a number of unifactorial prognostic indices have been employed in routine hospital practice, such as C-reactive protein (CRP), serum amylase and serum lipase. These serum enzymes are easy to obtain in normal clinical practice and many authors consider them as reliable as multi factorial scoring systems.Methods: A hospital based observational prospective study was done with 30 patients to measure C reactive protein levels in patients of acute pancreatitis and evaluate if CRP levels predict the severity of pancreatitis.Results: In cases where CRP was raised >100 mg/dl on day 7 and beyond showed either a complication or increased duration of stay and delayed recovery. This correspondence of CRP with the clinical outcome co related well with other parameters like blood counts, serum lipase and amylase levels too.Conclusions: Hence, CRP can be a very useful uni factorial tool in assessing and thereby predicting the outcome in a case of pancreatitis.

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Comparison of radiological scoring systems, clinical scores, neutrophil-lymphocyte ratio and serum C-reactive protein level for severity and mortality in acute pancreatitis

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.6.762 ◽

2020 ◽

Vol 66 (6) ◽

pp. 762-770

Author(s):

Naciye S Gezer ◽

Göksel Bengi ◽

Agah Baran ◽

Pakize E Erkmen ◽

Ömer S Topalak ◽

...

Keyword(s):

Computed Tomography ◽

Acute Pancreatitis ◽

Sensitivity And Specificity ◽

Protein Level ◽

Scoring Systems ◽

C Reactive Protein ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

Clinical Scores

SUMMARY Comparison of radiological scoring systems, clinical scores, neutrophil-lymphocyte ratio and serum C-reactive protein level for severity and mortality in acute pancreatitis BACKGROUND/AIMS To compare radiological scoring systems, clinical scores, serum C-reactive protein (CRP) levels and the neutrophil-lymphocyte ratio (NLR) for predicting the severity and mortality of acute pancreatitis (AP). MATERIALS AND METHODS Demographic, clinical, and radiographic data from 80 patients with AP were retrospectively evaluated. The harmless acute pancreatitis score (HAPS), systemic inflammatory response syndrome (SIRS), bedside index for severity in acute pancreatitis (BISAP), Ranson score, Balthazar score, modified computed tomography severity index (CTSI), extrapancreatic inflammation on computed tomography (EPIC) score and renal rim grade were recorded. The prognostic performance of radiological and clinical scoring systems, NLR at admission, and serum CRP levels at 48 hours were compared for severity and mortality according to the revised Atlanta Criteria. The data were evaluated by calculating the receiver operator characteristic (ROC) curves and area under the ROC (AUROC). RESULTS Out of 80 patients, 19 (23.8%) had severe AP, and 9 (11.3%) died. The AUROC for the BISAP score was 0.836 (95%CI: 0.735-0.937), with the highest value for severity. With a cut-off of BISAP ≥2, sensitivity and specificity were 68.4% and 78.7%, respectively. The AUROC for NLR was 0.915 (95%CI: 0.790-1), with the highest value for mortality. With a cut-off of NLR >11.91, sensitivity and specificity were 76.5% and 94.1%, respectively. Of all the radiological scoring systems, the EPIC score had the highest AUROC, i.e., 0.773 (95%CI: 0.645-0.900) for severity and 0.851 (95%CI: 0.718-0.983) for mortality, with a cut-off value ≥6. CONCLUSION The BISAP score and NLR might be preferred as early determinants of severity and mortality in AP. The EPIC score might be suggested from the current radiological scoring systems.

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Meta-analysis of the role of C-reactive protein in predicting severity of acute pancreatitis

Pancreatology ◽

10.1016/j.pan.2012.12.192 ◽

2013 ◽

Vol 13 (2) ◽

pp. e39-e40

Author(s):

T. Jin ◽

K. Altaf ◽

J.J. Xiong ◽

M.A. Javed ◽

W. Huang ◽

...

Keyword(s):

Acute Pancreatitis ◽

Meta Analysis ◽

C Reactive Protein ◽

Reactive Protein

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CO-RADS versus CT-SS scores in predicting severe COVID-19 patients: retrospective comparative study

Egyptian Journal of Bronchology ◽

10.1186/s43168-021-00060-3 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Niveen E. Zayed ◽

Manar A. Bessar ◽

Samah Lutfy

Keyword(s):

Comparative Study ◽

Severe Disease ◽

Scoring Systems ◽

Rt Pcr ◽

C Reactive Protein ◽

Reactive Protein ◽

Polymerase Chain ◽

Retrospective Comparative Study ◽

Rule Out

Abstract Background The role of CT in assessing and plotting viral pulmonary affection land marking is its potential among other investigation tools, and the aim of the study was to compare the ability of two different CT-based scoring systems in discriminating severe COVID-19 disease. Results Retrospective comparative study included 142 confirmed COVID-19 patients by real-time polymerase chain reaction (RT-PCR) test, with different degrees of disease (mild to severe), the data of patients collected from medical records, and patients with their first CT chest read for calculating CO-RADS and severity scoring system (CT-SS) score. The patients with severe COVID-19 disease were significantly older and had different comorbidities. The level of C-reactive protein, ESR, ferritin, and LDH were significantly higher in severe disease, P < 0.001. The ability of CT chest and its score bases (CT-SS and CO-RADS) were accurate in differentiation between mild/moderate and severe disease; AUC were 89% and 97%, respectively. The cutoff value of less than 7.5 and 4.5 for CT-SS and CO-RADS, respectively, can rule out severe COVID-19 by 90% and 97%, respectively. Conclusions CT chest play a segregate role in COVID-19 disease, add on an advantage in clinical data in triage, and highlight the decision of hospital admission.

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Comparison of sensitivity and specificity of serum poly-C avid ribonuclease activity and C-reactive protein concentration in detection of mild and severe acute pancreatitis

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm.2004.093 ◽

2004 ◽

Vol 42 (5) ◽

Cited By ~ 5

Author(s):

Beata Kuśnierz-Cabala ◽

Jerzy W. Naskalski ◽

Boguslaw Kędra ◽

Józefa Panek

Keyword(s):

Acute Pancreatitis ◽

Severe Acute Pancreatitis ◽

Clinical Course ◽

Function Analysis ◽

Necrotizing Pancreatitis ◽

Ribonuclease P ◽

C Reactive Protein ◽

Reactive Protein ◽

Acute Necrotizing ◽

Mild Acute Pancreatitis

AbstractThe aim of this study was to compare diagnostic performance of C-reactive protein (CRP) and poly-C avid ribonuclease (P-RNase) levels in the prediction of a severe clinical course of acute pancreatitis (AP). The study included 36 patients with mild and 20 with severe AP. CRP concentration was measured by an immunonephelometric method and P-RNase activity by the rate of polycytidylate hydrolysis at pH 7.8. At the time of admission, both P-RNase and CRP levels were significantly increased in all patients when compared to healthy subjects (29.2 vs. 18.7 U/l and 91.1 vs. 2.89 mg/l; p<0.001). Up to days 3 and 4 a further increase in P-RNase was observed. On the other hand, the increase in CRP continued only through days 2 and 3 (p<0.001). Severe acute pancreatitis (SAP) and mild acute pancreatitis (MAP) differed significantly with respect to P-RNase levels on all days studied; whereas CRP levels differed significantly on days 2–5 but did not differ at admission. Receiver operating characteristic (ROC) curve function analysis yielded the best sensitivity of SAP detection for P-RNase, equaling 72.2%, at the cut-off point value 65.3 U/l on day 3 after admission. The sensitivity of CRP for detection of SAP was 85.0% at 125.7 mg/l on the 2nd day after admission. Both parameters studied were significantly associated with the severity of the AP clinical course; however, on days 1 and 2 postadmission, P-RNase was more specific for detection of SAP than CRP (94.4% vs. 77.1% on the 1st day and 94.4% vs. 55.5% on the 2nd day). In conclusion, P-RNase has shown an excellent performance for early differentiation of acute necrotizing pancreatitis.

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C reactive protein as a prognostic indicator of severity in patients with acute pancreatitis

International Surgery Journal ◽

10.18203/2349-2902.isj20201391 ◽

2020 ◽

Vol 7 (4) ◽

pp. 1169

Author(s):

Bharath Nayak Ganesh ◽

Srinivas Nanjangud Masana Setty

Keyword(s):

Acute Pancreatitis ◽

Severe Disease ◽

Scoring Systems ◽

Prognostic Indicator ◽

P Value ◽

High Morbidity ◽

C Reactive Protein ◽

Systemic Complications ◽

Mild Disease ◽

Reactive Protein

Background: Acute pancreatitis ranges from a mild illness to a severe disease with high morbidity and mortality. Severity affects the treatment and outcome. The existing scoring systems for assessment of its severity require are time consuming and expensive. This study was an attempt to evaluate the effectiveness of C-reactive protein (CRP) as a prognostic indicator and a marker of severity of acute pancreatitis.Methods: This was a prospective observational study conducted between among 50 patients diagnosed with acute pancreatitis. The Ranson’s score and CTSI was calculated for these patients. CRP levels were measured 48 hours after the onset of symptoms. They were observed for the development of local and systemic complications, and outcome. These were compared with the CRP values. Pearson coefficient was used to study the correlation between the variables. A p value of less than 0.05 was considered to be statistically significant.Results: 30 of the 50 patients had no local complications. 14 patients (28%) had peripancreatic collection and 6 (12%) had pancreatic necrosis. 24 of the 50 patients had systemic complications (48%). 25 patients had mild disease and 25 had severe disease as evidenced by the Ranson’s score. These 25 patients with severe disease also had raised CRP (p<0.05). There was no statistically significant correlation between the CTSI and CRP values. 4 patients with CRP values more than 400 succumbed to the illness.Conclusions: CRP can serve as an inexpensive alternative to the conventional severity assessment methods for the prediction of severity and outcome of patients with acute pancreatitis.

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The Role of Serum Fibrinogen in Predicting Reinfection after DAIR (debridement, antibiotics, and implant retention) Treatment of Periprosthetic Joint Infections

10.21203/rs.3.rs-154467/v1 ◽

2021 ◽

Author(s):

Dacheng Zhao ◽

He Jinwen ◽

Wang Xingwen ◽

Zhao Xiaobing ◽

Bin Geng ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Operating Characteristic ◽

Characteristic Curve ◽

Joint Infection ◽

Diagnostic Value ◽

C Reactive Protein ◽

Reactive Protein ◽

Joint Infections ◽

Implant Retention

Abstract Background Fibrinogen (FIB) has been used to differentiate periprosthetic joint infection (PJI) from aseptic loosening. The purpose of this study was to evaluate the diagnostic value of FIB in predicting postoperative reinfection in patients with debridement, antibiotics and implant retention (DAIR). Methods We retrospectively analyzed the patients who were admitted to DAIR from January 2013 to August 2019 for consideration of PJI readmission. Subgroups were divided into subgroups based on whether there was reinfection after DAIR treatment, and the diagnostic value of serum fibrinogen, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) before DAIR treatment was analyzed by receiver operating Characteristic curve (ROC). To evaluate the diagnostic value of FIB in predicting postoperative reinfection in DAIR patients. Results FIB expression was different in acute PJI patients and chronic PJI patients treated with DAIR (4.03 VS 3.08; P < .05, 4.28 VS 3.68; P < .05). In patients with acute PJI treated with DAIR, the sensitivity and specificity of FIB were 81.82% and 83.33%, respectively, significantly higher than CRP (sensitivity, 72.73%; Specificity, 50%; P < .05), while the specificity was higher than ESR (specificity,41.67%; P < .05). In patients with chronic PJI treated with DAIR, the sensitivity and specificity of FIB were 80.00% and 66.66%, respectively, significantly higher than CRP (sensitivity, 53.33%; Specificity, 66.66%; P < .05), ESR (sensitivity was 66.00%; Specificity, 16.66 %; P < .05). Conclusion FIB can predict reinfection after DAIR treatment for acute or chronic PJI. Considering the low success rate of DAIR treatment for chronic PJI, it should be chosen carefully.

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471 C-Reactive Protein Accurately Predicts Severity of Acute Pancreatitis in Children

British Journal of Surgery ◽

10.1093/bjs/znab259.680 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

H Walker ◽

J Melling ◽

M Jones ◽

C Melling

Keyword(s):

Acute Pancreatitis ◽

Area Under Curve ◽

Roc Analysis ◽

Scoring Systems ◽

Serum Markers ◽

Receiver Operating Curve ◽

Organ Support ◽

First Episode ◽

C Reactive Protein ◽

Reactive Protein

Abstract Introduction Predicting severity of acute pancreatitis enables optimization of care, reducing morbidity and length of stay. Modified adult scoring systems have not yet been able to adequately predict severity in children. This study supports the use of CRP in children as a superior biomarker of acute pancreatitis severity compared with the modified Glasgow Pancreas score. Method This was a retrospective study of children presenting with a first episode of acute pancreatitis from 2002 - 2020 in a single tertiary paediatric surgical centre. Serum markers including CRP at 48 hours of admission were analysed. Statistical analysis included Receiver Operating Curve (ROC) analysis for promising biomarkers, and these were compared to the modified Glasgow Pancreas Score. A severe episode was defined by development of local complications and/or organ support. An Area Under Curve (AUC) >0.90 was defined as an excellent predictor of severity. Results Data of 59 children were analysed, median age 13 years, 22 (37%) patients had a severe episode. ROC analysis demonstrated CRP as the best predictor of severity, giving an AUC of 0.92. Optimum cut off value for CRP was 107. 5mg/L (p < 0.0001), producing 91% sensitivity and 84% specificity. This was significantly superior to the modified Glasgow Pancreas score, which gave an AUC of 0.66 (p < 0.0424) producing 36% sensitivity and 100% specificity. Conclusions We have shown that a CRP >107.5 within 48 hours of admission can be used to predict severity of acute pancreatitis in children with greater accuracy than current scoring systems.

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