scholarly journals CORRELATION OF SERUM CRP & LACTATE AS AN EARLY PREDICTOR OF STRANGULATION IN ACUTE ABDOMEN

2020 ◽  
Vol 7 (2) ◽  
pp. 181-188
Author(s):  
Saleem Tahir ◽  
Samaksh Giri ◽  
Shadab Asif ◽  
Brijesh Rathore
Keyword(s):  
Acute Abdomen ◽  
Diagnostic Value ◽  
Serum Lactate ◽  
C Reactive Protein ◽  
Predictive Values ◽  
Cutoff Value ◽  
Reactive Protein ◽  
Sensitivity Specificity ◽  
Serum Crp ◽  
Early Predictor

Strangulation in acute abdomen is one of the dangerous complication in patients of acute abdomen and early diagnosis is necessary for prevention of mortality. Present study was aimed to find whether serum C-Reactive Protein (CRP) and Serum Lactate can be used as early predictor for strangulation in cases of acute abdomen. A total of 75 patients with acute abdomen were included in the study. The serum CRP and Lactate values were measured preoperatively and correlated with intraop findings postoperatively. ROC curve was drawn and cutoff value for prediction of strangulation and mortality based on which diagnostic value was calculated. At cutoff level of 45.5 mg/L, CRP was 85.0% sensitive and 85.7% specific with positive and negative predictive values of 87.2% & 83.3% for prediction of strangulation in acute abdomen while sensitivity, specificity, PPV and NPV of Serum lactate was 100.0%, 91.4% 93.0% & 100.0% respectively using cutoff value ≥23.5mg/dl. Serum CRPand Lactate could be useful markers in predicting strangulation in cases of acute abdomen.

scholarly journals Combination of Serum C-reactive Protein and D-lactate: Predictors of Strangulation in Intestinal Obstruction

2016 ◽  
Vol 5 (3) ◽  
pp. 134-139 ◽  
Author(s):  
Ajay K Pal ◽  
Maulana M Ansari ◽  
Najmul Islam
Keyword(s):  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Acute Intestinal Obstruction ◽  
Emergency Setting ◽  
C Reactive Protein ◽  
Predictive Values ◽  
Cutoff Value ◽  
Reactive Protein ◽  
Sensitivity Specificity ◽  
Serum Crp

ABSTRACT Introduction Serum C-reactive protein (CRP) and D-lactate have been proposed as markers of intestinal ischemia. The purpose of this prospective observational study is to find whether serum CRP and serum D-lactate can help in predicting strangulation in cases of acute intestinal obstruction. Materials and methods A total of 50 consecutive patients were included in the study after excluding patients of comorbid medical illness and patients with findings other than obstruction or strangulation. The serum values of CRP and D-lactate were measured and compared between obstruction with strangulation and obstruction without strangulation. Receiver operating characteristic (ROC) curve was drawn and cutoff values for the diagnosis of strangulation were calculated along with calculation of sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs). Results A total of 14 patients who were diagnosed with strangulated bowel obstruction had significantly higher values of serum CRP and D-lactate when compared with 36 patients with simple bowel obstruction (116 vs 40 mg/L and 5.4 vs 2.7 mmol/L respectively, p < 0.05). Using ROC analysis, the area under the curve of serum CRP and D-lactate was found to be 0.785 and 0.775 respectively, for bowel strangulation. Using a cutoff value of 60 mg/L for CRP, the sensitivity, specificity, PPV, and NPV were 87.5, 58.3, 48.3, 91.3% respectively. Using a cutoff value of 4.5 mmol/L for D-lactate, the sensitivity, specificity, PPV, and NPV were 75.0, 69.4, 52.7, 86.2% respectively. Conclusion Serum CRP and D-lactate can be useful and reasonable markers for predicting strangulation in cases of acute intestinal obstruction in an emergency setting. How to cite this article Pal AK, Ansari MM, Islam N. Combination of Serum C-reactive Protein and D-lactate: Predictors of Strangulation in Intestinal Obstruction. Panam J Trauma Crit Care Emerg Surg 2016;5(3):134-139.

C-reactive protein as a predictor of meningitis in early onset neonatal sepsis: a single unit experience

2020 ◽  
Vol 48 (8) ◽  
pp. 845-851 ◽  
Author(s):  
Naveed Ur Rehman Durrani ◽  
Sourabh Dutta ◽  
Niels Rochow ◽  
Salhab el Helou ◽  
Enas el Gouhary
Keyword(s):  
Early Onset ◽  
Neonatal Intensive Care ◽  
C Reactive Protein ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Reactive Protein ◽  
Early Onset Sepsis ◽  
Polymerase Chain ◽  
Sensitivity Specificity ◽  
Serum Crp

AbstractObjectivesTo determine whether there is a cut off value of serum C-reactive protein (CRP) associated with a higher risk of meningitis in suspected early onset sepsis (EOS) (onset birth to 7 days of life).MethodsA retrospective cohort study on neonates admitted in neonatal intensive care unit at McMaster Children’s Hospital from January 2010 to 2017 and had lumbar puncture (LP) and CRP for workup of EOS. Included subjects had either (a) non-traumatic LP or (b) traumatic LP with cerebral spinal fluid (CSF) polymerase chain reaction or gram stain or culture-positive or had received antimicrobials for 21 days. Excluded were CSF done for metabolic errors, before cytomegalovirus (CMV) treatment; from ventriculo-peritoneal (VP) shunts; missing data and contamination. Neonates were classified into definite and probable meningitis and on the range of CRP. We calculated sensitivity, specificity, and likelihood ratios for CRP values; and area under the receiver operating characteristic (AUROC) curve.ResultsOut of 609 CSF samples, 184 were eligible (28 cases of definite or probable meningitis and 156 controls). Sensitivity, specificity, predictive values, likelihood ratios, and AUROC were too low to be of clinical significance to predict meningitis in EOS.ConclusionsSerum CRP values have poor discriminatory power to distinguish between subjects with and without meningitis, in symptomatic EOS.

scholarly journals Role Of C-Reactive Protein in Diagnosis of Acute Appendicitis

2021 ◽  
Vol 10 (4) ◽  
pp. 210-214
Author(s):  
Mirza Tassawar Hussain ◽  
Muhammad Kashif Khan ◽  
Syed Shamsuddin ◽  
Aabid Ali ◽  
Erum Khan ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
C Reactive Protein ◽  
Diagnostic Dilemma ◽  
Senior Registrar ◽  
Predictive Values ◽  
Reactive Protein ◽  
Highly Sensitive ◽  
Sensitivity Specificity

Background: Appendicitis is a common surgical emergency and diagnostic dilemma. Making the correct diagnosis is often difficult as the clinical presentation varies according to the age of the patient and the position of appendix. The objective of this study was to identify clinical applicability of C- reactive protein, as a diagnostic test for appendicitis. Methods: This prospective study was carried out in Federal government Polyclinic hospital, Islamabad from January to July 2019, 114 patients underwent appendectomy for clinically diagnosed acute appendicitis. The decision to operate the patient was given by senior registrar. The blood samples for C-reactive protein were drawn before taking the patient to the operating theatre. Removed appendices were sent for histopathological confirmation of diagnosis. The C-reactive protein was then compared with the results of histopathology to determine its validity. The data was entered and analysed in SPSS 23. Results: The sensitivity, specificity, positive and negative predictive values of C-reactive protein in patients with clinical diagnosis of acute appendicitis were found to be 94%, 78%, 93% and 74 % respectively. Conclusion: CRP is helpful in making diagnosis of acute appendicitis. It is highly sensitive but has a relatively low specificity.  

Diagnostic Value of Urine sTREM-1 and Urine C-reactive Protein for Infants with Late Onset Neonatal Sepsis

2019 ◽  
Vol 15 (02) ◽  
pp. 072-078
Author(s):  
Senem Alkan Ozdemir ◽  
Ruya Colak ◽  
Ezgi Yangin Ergon ◽  
Sebnem Calkavur
Keyword(s):  
Neonatal Sepsis ◽  
Predictive Value ◽  
Late Onset ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Late Onset Sepsis ◽  
Noninvasive Markers ◽  
Serum Crp ◽  
Sepsis Detection

Abstract Objective Noninvasive markers have been increasingly used as a diagnostic marker for sepsis detection and monitoring of the disease. The aim of this observational, prospective pilot study was to investigate the diagnostic performance of urinary soluble triggering receptor expressed on myeloid cells (sTREM-1) and urine C-reactive protein (CRP) levels in the late onset neonatal sepsis and to compare them with serum CRP levels. Materials and Methods Sixty-six infants with clinical sepsis were included. Urine sTREM-1 and urine CRP were collected at the diagnosis of late-onset sepsis. All laboratory investigations were also noted from the infants. Results There were no significant differences between characteristics of the infants. Culture-positive neonates had significantly higher urine sTREM-1 than culture-negative neonates (p < 0.001). Using a cut-off point for urine sTREM-1 of 129 pg/mL, the sensitivity was 0.63, the specificity was 0.84, positive predictive value was 0.80, negative predictive value was 0.70. Urine sTREM-1 and urine CRP were recollected on the seventh day of sepsis treatment and it was found that the levels of sTREM-1 and CRP decreased. Conclusion This is the first study in the literature which evaluates the place of urine sTREM-1 and urine CRP in the diagnosis of neonatal sepsis. Urine sTREM-1 and urine CRP may be useful in the diagnosis of sepsis and in evaluating the effect of antibiotic treatment.

scholarly journals Soluble myeloid triggering receptor expressed on myeloid cell 1 might have more diagnostic value for bacterial ascites than C-reactive protein

2018 ◽  
Vol 13 (1) ◽  
pp. 456-462
Author(s):  
Qiang Guo ◽  
Chuanqin Xu ◽  
Chao Sun ◽  
Yubao Zhao ◽  
Weifu Zhang
Keyword(s):  
Predictive Value ◽  
Myeloid Cell ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Control Group ◽  
Health Examination ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Sensitivity Specificity ◽  
Medical University

AbstractThe timely and accurate diagnosis of ascites is of great significance for early treatment and prognostication. This study explored the value of soluble myeloid triggering receptor expressed on myeloid cell 1 (sTREM-1) and C-reactive protein (CRP) for assessing ascites. A total of 133 patients with ascites who received treatment at the Affiliated Hospital of Taishan Medical University between September 2015 and September 2017 were retrospectively analyzed. The ascites in 22, 45, 33 and 33 patients were tuberculous, bacterial, tumorous, and transudative, respectively. Healthy volunteers (n=30) who received a health examination at the same hospital during the same period constituted the control group. Before treatment, both ascitic sTREM-1 and CRP showed significant differences among the ascites subgroups (P<0.001), with the highest levels in the bacterial subgroup. Serum sTREM-1 and CRP also showed significant differences among the groups. A correlation analysis showed a positive correlation between sTREM-1 and CRP. ROC curves of the bacterial subgroup showed that when the optimal cutoff point was set to 20.2, the sensitivity, specificity, positive predictive value, and negative predictive value of the serum sTREM-1 index were 0.933, 0.955, 0.914, and 0.965, respectively. sTREM-1 may provide more diagnostic value than CRP for the diagnosis of bacterial ascites.

scholarly journals The Diagnostic Value of the Pleural Fluid C-Reactive Protein in Parapneumonic Effusions

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Shimon Izhakian ◽  
Walter G. Wasser ◽  
Benjamin D. Fox ◽  
Baruch Vainshelboim ◽  
Mordechai R. Kramer
Keyword(s):  
Heart Failure ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Predictive Value ◽  
Medical Center ◽  
Diagnostic Value ◽  
Parapneumonic Effusion ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Sensitivity Specificity

Purpose. The aim of this study was to evaluate the sensitivity of pleural C-reactive protein (CRP) biomarker levels in identifying parapneumonic effusions.Methods. A single-center, retrospective review of 244 patients diagnosed with pleural effusions was initiated among patients at the Rabin Medical Center, Petah Tikva, Israel, between January 2011 and December 2013. The patients were categorized into 4 groups according to their type of pleural effusion as follows: heart failure, malignant, post-lung transplantation, and parapneumonic effusion.Results. The pleural CRP levels significantly differentiated the four groups (p<0.001) with the following means: parapneumonic effusion,5.38±4.85 mg/dL; lung transplant,2.77±2.66 mg/dL; malignancy,1.19±1.51 mg/dL; and heart failure,0.57±0.81 mg/dL. The pleural fluid CRP cut-off value for differentiating among parapneumonic effusions and the other 3 groups was 1.38 mg/dL. The sensitivity, specificity, positive predictive value, and negative predictive value were 84.2%, 71.5%, 37%, and 95%, respectively. A backward logistic regression model selected CRP as the single predictor of parapneumonic effusion (OR = 1.59, 95% CI = 1.37–1.89).Conclusions. Pleural fluid CRP levels can be used to distinguish between parapneumonic effusions and other types of exudative effusions. CRP levels < 0.64 mg/dL are likely to indicate a pleural effusion from congestive heart failure, whereas levels ≥ 1.38 mg/dL are suggestive of an infectious etiology.

scholarly journals The Diagnostic Value of Serum Gastrin-17 and Pepsinogen for Gastric Cancer Screening in Eastern China

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hongzhang Shen ◽  
Kangwei Xiong ◽  
Xiangyu Wu ◽  
Sile Cheng ◽  
Qifeng Lou ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Eastern China ◽  
Intraepithelial Neoplasia ◽  
Diagnostic Value ◽  
Diagnostic Efficiency ◽  
Predictive Values ◽  
Cutoff Value ◽  
Cutoff Values ◽  
Significant Difference ◽  
Sensitivity Specificity

Objective. To evaluate the diagnostic value of gastrin-17 (G-17) and pepsinogen (PG) in gastric cancer (GC) screening in China, especially eastern China, and to determine the best diagnostic combination and threshold (cutoff values) to screen out patients who need gastroscopy. Methods. The serum concentrations of G-17 and pepsinogen I and II (PGI and PGII) in 834 patients were analyzed, and the PGI/PGII ratio (PGR) was calculated. According to pathological results, patients can be divided into chronic nonatrophic gastritis (NAG)/chronic atrophic gastritis (CAG)/intraepithelial neoplasia (IN)/GC groups. The differences in G-17, PG, and PGR in each group were analyzed, and their values in GC diagnosis were evaluated separately and in combination. Results. There were differences in serum G-17, PGII, and PGR among the four groups (NAG/CAG/IN/GC) ( P ≤ 0.001 ). In total, 54 GC cases were diagnosed, of which 50% were early GC. There was no significant difference in the PGI levels among the four groups ( P = 0.377 ). NAG and CAG composed the chronic gastritis (CG) group. The G-17 and PGII levels in the IN and GC groups were higher than those in the CG group (both P ≤ oth   C ), while the PGR levels were lower ( P ≤ lower ). When distinguishing NAG from CAG, the best cutoff value for G-17 was 9.25 pmol/L, PGII was 7.06 μg/L, and PGR was 12.07. When distinguishing CG from IN, the best cutoff value for G-17 was 3.86 pmol/L, PGII was 11.92 μg/L, and PGR was 8.26. When distinguishing CG from GC, the best cutoff value for G-17 was 3.89 pmol/L, PGII was 9.16 μg/L, and PGR was 14.14. The sensitivity, specificity, accuracy, and positive and negative predictive values of G-17/PGII/PGR for GC diagnosis were 83.3%/70.4%/79.6%, 51.8%/56.3%/47.8%, 53.8%/57.2%/49.9%, 10.7%/10.9%/9.6%, and 97.8%/96.5%/97.1%, respectively. The sensitivity, specificity, accuracy, and positive predictive and negative predictive values of PGII/G-17 vs. PGR/G-17 vs. PGR/PGII in the diagnosis of GC were 63.0% vs. 70.4% vs. 64.8%, 70.5% vs. 70.1% vs. 60.4%, 70.0% vs. 70.1% vs. 60.7%, 12.9% vs. 14.0% vs. 10.2%, and 96.5% vs. 97.2% vs. 96.1%, respectively. Conclusion. The PGII and G-17 levels in patients with gastric IN and GC were significantly increased, while the serum PGR level was significantly decreased. Serological detection is effective for screening GC. The combination of different markers can improve the diagnostic efficiency. The highest diagnostic accuracy was G-17 combined with PGR, and the best cutoff values were G − 17 > 3.89   pmol / L and PGR < 14.14 .

Diagnostic Value of Interleukin-6 and C-Reactive Protein in Acute Appendicitis

Swiss Surgery ◽  
2000 ◽  
Vol 6 (4) ◽  
pp. 169-172 ◽  
Author(s):  
Erkasap ◽  
Ates ◽  
Ustuner ◽  
Sahin ◽  
Yilmaz ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Interleukin 6 ◽  
Iliac Fossa ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Perforated Appendix ◽  
Right Iliac Fossa Pain ◽  
The Mean ◽  
Serum Crp

The aim of this study is prospectively to evaluate the serum C-reactive protein (CRP) and interleukin-6 (IL-6) levels in detection of acute appendicitis in patients with right iliac fossa pain. Data were collected in prospective manner on 102 consecutive patients with right iliac fossa pain. Laparotomy was performed for suspected acute appendicitis for 55 of the 102 patients, of whom 49 patients had appendicitis, 6 patients non-appendicitis (NA), and the other 47 patients had nonspecific abdominal pain (NSAP) and they did not undergo operation. Among those with appendicitis 31 had acute appendix (AA), 8 had gangrenous appendix (GA), and 10 had perforated appendix (PA). The WBC and CRP the mean (SEM) values were significantly different in AA, GA, and PA groups compared with NSAP and NA groups (P < 0.05). Although the mean IL-6 levels were significantly different only in PA group than the others groups (P < 0.05). The sensitivity and specificity of serum CRP measurements were calculated as 96% and 87%, respectively whereas these were 33% and 83% for IL-6 levels for the diagnosis of the acute appendicitis. As a result, measurement of the CRP levels and WBC have an additional diagnostic value on the diagnosis of the acute appendicitis but determination of IL-6 levels which added to the test combination of WBC and CRP, the sensitivity for the diagnosis of the acute appendicitis was not changed whereas the specificity was decreased to 66%.

DIAGNOSTIC VALUE OF LABORATORY MARKERS OF NEONATAL SEPSIS IN PREMATURE INFANTS

2021 ◽  
Vol 100 (1) ◽  
pp. 95-100
Author(s):  
G.V. Kulizhnikov ◽  
◽  
E.G. Furman ◽  
A.V. Nikolenko ◽  
◽  
...  
Keyword(s):  
Premature Infants ◽  
Neonatal Sepsis ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Diagnostic Significance ◽  
Reactive Protein ◽  
Advantages And Disadvantages ◽  
Negative Results ◽  
Laboratory Markers ◽  
Sensitivity Specificity

Neonatal sepsis (NS) is the leading cause of mortality in premature newborns. It is a difficult diagnostic task for clinicians. This article provides a review of the literature on laboratory markers of NS. The latest methods for the diagnosis of sepsis in premature infants in various studies are considered in the article. The results of studying the diagnostic value of a general blood test, cytokines, C-reactive protein, procalcitonin, prespepsin, microRNA polymorphism, bacterial blood culture, their advantages and disadvantages, as well as diagnostic significance – sensitivity, specificity, prognostic value of positive and negative results are presented.

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