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

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.

scholarly journals Multifactorial Scores and Biomarkers of Prognosis of Acute Pancreatitis: Applications to Research and Practice

2020 ◽  
Vol 21 (1) ◽  
pp. 338 ◽  
Author(s):  
Pedro Silva-Vaz ◽  
Ana Margarida Abrantes ◽  
Miguel Castelo-Branco ◽  
António Gouveia ◽  
Maria Filomena Botelho ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Biochemical Markers ◽  
Scoring Systems ◽  
Sudden Onset ◽  
Special Focus ◽  
High Morbidity ◽  
Aggressive Approach ◽  
Systemic Complications ◽  
Mild Disease ◽  
Local And Systemic Complications

Acute pancreatitis (AP) is a severe inflammation of the pancreas presented with sudden onset and severe abdominal pain with a high morbidity and mortality rate, if accompanied by severe local and systemic complications. Numerous studies have been published about the pathogenesis of AP; however, the precise mechanism behind this pathology remains unclear. Extensive research conducted over the last decades has demonstrated that the first 24 h after symptom onset are critical for the identification of patients who are at risk of developing complications or death. The identification of these subgroups of patients is crucial in order to start an aggressive approach to prevent mortality. In this sense and to avoid unnecessary overtreatment, thereby reducing the financial implications, the proper identification of mild disease is also important and necessary. A large number of multifactorial scoring systems and biochemical markers are described to predict the severity. Despite recent progress in understanding the pathophysiology of AP, more research is needed to enable a faster and more accurate prediction of severe AP. This review provides an overview of the available multifactorial scoring systems and biochemical markers for predicting severe AP with a special focus on their advantages and limitations.

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

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.

scholarly journals Impact of Fatty Liver on Acute Pancreatitis Severity

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Seung Bae Yoon ◽  
In Seok Lee ◽  
Moon Hyung Choi ◽  
Kyungjin Lee ◽  
Hyoju Ham ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Fatty Liver ◽  
C Reactive Protein ◽  
Prognostic Role ◽  
Hounsfield Units ◽  
Mild Disease ◽  
Reactive Protein ◽  
Unenhanced Ct ◽  
Liver Changes ◽  
The Relationship

Aim. Acute pancreatitis is typically a mild disease, but some patients develop severe courses. Fatty liver changes are seen in patients with acute pancreatitis, but its clinical significance has not been well-studied. We aimed to investigate the relationship between fatty liver and the severity of acute pancreatitis. Methods. Unenhanced CT images of patients with acute pancreatitis were retrospectively reviewed by a radiologist, and mean hepatic and splenic attenuation was measured in Hounsfield units (HU). Fatty liver was defined as mean hepatic/splenic HU<1. Results. Among 200 patients, fatty liver was found in 67 (33.5%) and nonfatty liver in 133 (66.5%). Compared with patients without fatty liver, the severity of pancreatitis and levels of serum C-reactive protein were higher in fatty liver patients. The prevalence of local complications, persistent organ failure, and mortality were also higher in patients with fatty liver. Even after adjusting for age, sex, body mass index, and cause of pancreatitis, fatty liver was significantly associated with moderately severe or severe acute pancreatitis. Conclusions. Fatty liver may play a prognostic role in acute pancreatitis. Fatty liver could be incorporated into future predictive scoring models.

scholarly journals The various prognostic scoring system used for predicting COVID-19 mortality

2021 ◽  
Vol 8 (9) ◽  
pp. 4611
Author(s):  
Khaled Mohamed Elsharkawy ◽  
Mohammed Abdulaziz Aljawi ◽  
Hani Helal Alhassani ◽  
Sadeen Essam Ezzat ◽  
Ziad Abdulmoti Alruwaithi ◽  
...  
Keyword(s):  
Scoring System ◽  
Severe Disease ◽  
Scoring Systems ◽  
Medical Attention ◽  
C Reactive Protein ◽  
X Ray ◽  
Reactive Protein ◽  
X Ray Imaging ◽  
Chest X Ray ◽  
Prognostic Scoring Systems

The widespread pandemic of Coronavirus disease 2019 (COVID-19) has been reported to affect most countries all over the world, and burden all of the affected healthcare systems. COVID-19 has first emerged in December 2019 within the district of Wuhan which is located in China. Many prognostic scoring systems have been developed to predict severe disease and death for patients with COVID-19. In this literature review, the aim to discuss the various prognostic scoring system used for predicting COVID-19 mortality. It has mainly approached the prognostic scoring systems in two main ways: The clinical and biochemical ways. In addition, the research also investigates the chest X-ray imaging findings based on scoring systems for predicting mortality for patients with COVID-19. Many scoring systems have been reported based on the biochemical and clinical parameters as age, D-dimer, presence of comorbidities, procalcitonin, C-reactive protein (CRP) and other features. Some of the reported scoring systems were recently developed in the COVID-19 pandemic while others were just modified based on the fact that patients with COVID-19 are critically ill, and usually require the same medical attention as other conditions. These scoring systems should be considered by clinicians to early predict and intervene against severe COVID-19 that might cause death. As for the imaging modalities, we have also reported many of the reported systems in the literature, including the ones that are based on chest computed tomography and X-ray findings, and are discussed in detail within this study.

scholarly journals CORRELATION BETWEEN SERUM C-REACTIVE PROTEIN LEVEL WITH SEVERITY OF THE DISEASE IN COVID-19 PATIENTS

2021 ◽  
Vol 5 (11) ◽  
Author(s):  
Sangeeta Gahlot ◽  
Surendra Yadav ◽  
Makkhan Lal Saini
Keyword(s):  
Severe Disease ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
P Value ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Group I ◽  
Moderate Disease ◽  
Severity Of The Disease

Background: To find the levels of serum CRP in confirmed Covid-19 patients and to compare their levels in patients with mild to moderate disease and patients with severe disease who required ICU care for management. Methods: A Cross sectional study was carried out on 100 confirmed cases of Covid-19, in whom Serum levels of Random sugar (RBS), Creatinine, Urea, C- reactive protein (CRP) were measured. Results: The levels of serum Urea, Creatinine were significantly increased in group II when compared to group 1, and the levels of CRP were significantly increased with p value <0.0001 in group IIwhen compared to group I. Conclusion: Findings of our study suggest that determination of biochemical parameters like CRP at the time of hospitalization helps in predicting the severity of disease and need for ICU for better treatment management and prevention of adverse outcome. Keywords: Severe acute respiratory syndrome, Covid-19, C- reactive protein, Intensive care unit.

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

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) &gt;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 &lt; 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 &lt; 0.0424) producing 36% sensitivity and 100% specificity. Conclusions We have shown that a CRP &gt;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.

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

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.

scholarly journals Predictive values of biochemical markers as early indicators for severe COVID-19 cases in admission

2021 ◽  
Author(s):  
Emin Gemcioglu ◽  
Mehmet Davutoglu ◽  
Ramis Catalbas ◽  
Berkan Karabuga ◽  
Enes Kaptan ◽  
...  
Keyword(s):  
Biochemical Markers ◽  
Severe Disease ◽  
High Morbidity ◽  
C Reactive Protein ◽  
Prognostic Information ◽  
Protein Ratio ◽  
Predictive Values ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
The Relationship

Aim: COVID-19 is a pandemic that causes high morbidity and mortality, especially in severe patients. In this study, we aimed to search and explain the relationship between biochemical markers, which are more common, easily available and applicable to diagnose and to stage the disease. Materials & methods: In this study, 609 patients were evaluated retrospectively. 11 biochemical parameters were included in analysis to explain the relationship with severity of disease. Results: Nearly, all the parameters that have been evaluated in this study were statistically valuable as a predictive parameter for severe disease. Areas under the curve of blood urea nitrogen (BUN)/albumin ratio (BAR), CALL score and lymphocyte/C-reactive protein ratio were 0.795, 0.778 and 0.770. The BUN/BAR and neutrophil/albumin ratios provide important prognostic information for decision-making in severe patients with COVID-19. Conclusion: High BUN/BAR and neutrophil/albumin ratios may be a better predictor of severity COVID-19 than other routinely used parameters in admission.

scholarly journals Serial estimation of serum myeloperoxidase in patients of acute pancreatitis: A pilot study

2021 ◽  
Vol 3 (2) ◽  
pp. 43-50
Author(s):  
Faraz Ahmed ◽  
Gursagar Singh Sahota ◽  
Vijay Kumar Singh ◽  
Anit Parihaar ◽  
Wahid Ali ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pilot Study ◽  
Colorimetric Assay ◽  
Severe Disease ◽  
Severity Index ◽  
Prognostic Indicator ◽  
Cross Sectional ◽  
Systemic Complications ◽  
Abdominal Symptoms ◽  
The Mean

Acute pancreatitis (AP) is an inflammatory condition having varied presentation ranging from a mild self-limiting illness to a severe disease with multi organ failure. Excessive recruitment of leukocytosis is an important pathophysiological feature and Myelo-peroxidase (MPO) forms an important part of neutrophil induced inflammation. The current prognostic criteria are complex and cumbersome.: The present cross sectional pilot study serial estimation of plasma MPO levels were done at the time of admission and on 3, 7 and 14 days in patient of Acute Pancreatitis (n=64) patient with acute abdominal symptoms (n=15) otherthan acute pancreatitidand healthy volunteers (n=15). The values of serum MPO levels were correlated with Ransons`s score, Apache score, CT severity index and patient developing local and systemic complications due to acute pancreatitis. Serum MPO levels in (mU/ml) were measured by colorimetric Assay kit (bio Vision, USA). Statistical Analysis on SPSS (Windows version 21.0): The mean serum MPO levels were significantly high in patients of AP as compared to controls comprising of patients with acute abdominal conditions and healthy individuals (mean 12.73 vs 1.67 mU/ml. p&#60; 0.001). The highest levels of serum MPO were observed on the first day of mild and severe AP. The mean MPO levels in mild diseases (n=21 patients) were 3-10 mU/ml and 10-20 mU/ml in severe AP (n=43 patients) who also experienced higher local complications and worse outcome in terms of mortality. MPO returned to normal levels within 7-10days in mild but were persistently raised in patients with severe diseases. The higher serum MPO levels correlated with more severe diseases, worse outcome and can be a simple and effective prognostic indicator in AP.

scholarly journals Do Normal Leucocyte Count and C-Reactive Protein on Admission to Hospital Exclude a Life-Threatening Attack of Acute Pancreatitis?

2002 ◽  
Vol 91 (4) ◽  
pp. 353-356 ◽  
Author(s):  
M. T. Hämäläinen ◽  
P. Grönroos ◽  
J. M. Grönroos
Keyword(s):  
Acute Pancreatitis ◽  
Leucocyte Count ◽  
Disease Group ◽  
C Reactive Protein ◽  
Mild Disease ◽  
Reactive Protein ◽  
Number Of Patients ◽  
Life Threatening ◽  
Group A ◽  
Group B

Background and Aims: The early severity assessment of an attack of acute pancreatitis is clinically of utmost importance. The aim of the present work was to study the role of leucocyte count and C-reactive protein (CRP) measurements on admission to hospital in assessing the severity of an attack of acute pancreatitis. In particular, patients with a life-threatening attack of acute pancreatitis but a normal leucocyte count and CRP level were sought. Material and Methods: A total of 1050 attacks of acute pancreatitis were treated at Turku University Central Hospital during the years 1995–1999. Leucocyte count and C-reactive protein (CRP) value were determined on admission to hospital. There were 58 life-threatening attacks of acute pancreatitis (group A). Fifty-eight consecutive mild attacks served as controls (group B). The number of patients with both values normal, only leucocyte count raised, only CRP level raised and both values raised were calculated in the groups A and B. Results: Both leucocyte count and CRP level were significantly ( P < 0.001 in both comparisons) higher on admission to hospital in patients with a life-threatening disease (group A) than in those with a mild disease (group B). Group A contained no patients with both values in the normal range. In group B, one fifth of the patients had both values normal. Conclusion: It is very unlikely that acute pancreatitis proves to be a life-threatening one when both the leucocyte count and CRP are normal on admission to hospital. In the present 1050 acute pancreatitis there were no patients with life-threatening disease but normal laboratory values on admission.

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