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.

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.

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.


2020 ◽  
Vol 9 (7) ◽  
pp. 2315 ◽  
Author(s):  
Orianne Villard ◽  
David Morquin ◽  
Nicolas Molinari ◽  
Isabelle Raingeard ◽  
Nicolas Nagot ◽  
...  

Background. The new coronavirus SARS-CoV-2, responsible for the Covid-19 pandemic, uses the angiotensin converting enzyme type 2 (ACE2), a physiological inhibitor of the renin angiotensin aldosterone system (RAAS), as a cellular receptor to infect cells. Since the RAAS can induce and modulate pro-inflammatory responses, it could play a key role in the pathophysiology of Covid-19. Thus, we aimed to determine the levels of plasma renin and aldosterone as indicators of RAAS activation in a series of consecutively admitted patients for Covid-19 in our clinic. Methods. Plasma renin and aldosterone levels were measured, among the miscellaneous investigations needed for Covid-19 management, early after admission in our clinic. Disease severity was assessed using a seven-category ordinal scale. Primary outcome of interest was the severity of patients’ clinical courses. Results. Forty-four patients were included. At inclusion, 12 patients had mild clinical status, 25 moderate clinical status and 7 severe clinical status. In univariate analyses, aldosterone and C-reactive protein (CRP) levels at inclusion were significantly higher in patients with severe clinical course as compared to those with mild or moderate course (p < 0.01 and p = 0.03, respectively). In multivariate analyses, only aldosterone and CRP levels remained positively associated with severity. We also observed a positive significant correlation between aldosterone and CRP levels among patients with an aldosterone level greater than 102.5 pmol/L. Conclusions. Both plasmatic aldosterone and CRP levels at inclusion are associated with the clinical course of Covid-19. Our findings may open new perspectives in the understanding of the possible role of RAAS for Covid-19 outcome.


2019 ◽  
Vol 316 (6) ◽  
pp. G806-G815 ◽  
Author(s):  
Ruma G. Singh ◽  
Aya Cervantes ◽  
Jin Uk Kim ◽  
Ngoc Nhu Nguyen ◽  
Steve V. DeSouza ◽  
...  

Ectopic fat and abdominal adiposity phenotypes have never been studied holistically in individuals after acute pancreatitis (AP). The aim of the study was to investigate phenotypical differences in ectopic fat and abdominal fat between individuals after AP (with and without diabetes) and to determine the role of pancreatitis-related factors. Eighty-four individuals were studied cross-sectionally after a median of 21.5 mo since last episode of AP and were categorized into “diabetes” and “no diabetes” groups. Twenty-eight healthy volunteers were also recruited. With the use of magnetic resonance imaging, intrapancreatic fat percentage, liver fat percentage, visceral fat volume (VFV), subcutaneous fat volume, and visceral-to-subcutaneous (V/S) fat volume ratio were quantified. Analysis of variance was used to investigate the differences in these phenotypes between the groups. All analyses were adjusted for age and sex. Linear regression analysis was used to investigate the association between pancreatitis-related factors and the studied phenotypes. Intrapancreatic fat percentage was significantly higher in the diabetes group (10.2 ± 1.2%) compared with the no diabetes (9.2 ± 1.7%) and healthy volunteers (7.9 ± 1.9%) groups ( P < 0.001). VFV was significantly higher in the diabetes (2,715.3 ±1,077.6 cm3) compared with no diabetes (1,983.2 ± 1,092.4 cm3) and healthy volunteer (1,126.2 ± 740.4 cm3) groups ( P < 0.001). V/S fat volume ratio was significantly higher in the diabetes (0.97 ± 0.27) compared with no diabetes (0.68 ± 0.42) and healthy volunteer (0.52 ± 0.34) groups ( P = 0.001). Biliary AP was associated with significantly higher intrapancreatic fat percentage (β = 0.67; 95% CI, 0.01, 1.33; P = 0.047). C-reactive protein levels during hospitalization for AP were associated with significantly higher VFV (β = 3.32; 95% CI, 1.68, 4.96; P < 0.001). In conclusion, individuals with diabetes after AP have higher intrapancreatic fat percentage, VFV, and V/S fat volume ratio. Levels of C-reactive protein during AP are significantly associated with VFV, whereas biliary AP is significantly associated with intrapancreatic fat percentage. NEW & NOTEWORTHY Individuals with diabetes after acute pancreatitis have significantly higher intrapancreatic fat percentage and visceral fat volume compared with individuals without diabetes after acute pancreatitis and healthy controls. C-reactive protein levels during hospitalization for acute pancreatitis and biliary etiology of acute pancreatitis are associated with significantly larger visceral fat and pancreatic fat depots, respectively.


Pancreatology ◽  
2013 ◽  
Vol 13 (2) ◽  
pp. e39-e40
Author(s):  
T. Jin ◽  
K. Altaf ◽  
J.J. Xiong ◽  
M.A. Javed ◽  
W. Huang ◽  
...  

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Niveen E. Zayed ◽  
Manar A. Bessar ◽  
Samah Lutfy

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.


2020 ◽  

Objective: In this study, we aimed to explore the role of the plasma presepsin level in patients with community-acquired pneumonia during admission to the emergency department in assessing the diagnosis, severity, and prognosis of the disease. In addition, we wanted to investigate the relationship of presepsinin with procalcitonin, C-reactive protein and pneumonia severity scores. Methods: One hundred twenty-three patients over the age of 18 who presented with a diagnosis of pneumonia to the emergency department were included in the study. The vital signs, symptoms, examination findings, background information, laboratory results, and radiological imaging results of the patients were recorded. The 30-day mortality rates of the patients were determined. Results: A statistically significant difference was found between the presepsin levels of the patients diagnosed with pneumonia and those of healthy subjects (p < 0.05). The plasma presepsin levels of the patients who died (8.63 ± 6.46) were significantly higher than those of the patients who lived (5.82 ± 5.97) (p < 0.05). The plasma procalcitonin and C-reactive protein levels of the dead patients were significantly higher than those living (p < 0.05). A presepsin cut-off value of 3.3 ng/mL for 30-day mortality was established (AUROC, 0.65; specificity, 45%; sensitivity, 82%). Procalcitonin is the most successful biomarker in the determination of mortality (AUROC, 0.70). A significant correlation was available between presepsin and lactate, C-reactive protein and procalcitonin (p < 0.05). There was a significant correlation between the Pneumonia Severity Index values and presepsin levels (p < 0.001, r = 0.311). Conclusion: The plasma presepsin level can be utilized for diagnosing community-acquired pneumonia. Plasma presepsin, procalcitonin and C-reactive protein levels can be used to predict the severity and mortality of community-acquired pneumonia.


Sign in / Sign up

Export Citation Format

Share Document