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Category: Volume 07 Issue 08 August 2019
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Title: Predictive power of Serum C-reactive protein in the Prognostication of Acute Pancreatitis

Authors: Rakesh Praveen Raj M.R., Reeja R.

 DOI: https://dx.doi.org/10.18535/jmscr/v7i8.80

Abstract

Background: The assessment of severity in acute pancreatitis is very important as 20% of cases can progress to serious life-threatening events.  Several multifactorial scoring systems are widely used; but they are too cumbersome to use in daily clinical practice. A single test which has a predictive power of prognostication is serum C-reactive protein.

Aims: To assess the relative accuracy of serum C-reactive protein and Ranson’s scoring system in predicting the severity of acute pancreatitis. To evaluate the accuracy of serum C-reactive protein in monitoring the clinical course of the disease

Materials and Methods: it is a prospective study done on all patients admitted in the institution over a period of one year, who were diagnosed with acute pancreatitis.

Results: A total of 42 patients were studied. Thirty patients had mild acute pancreatitis and 12 had severe. Ranson’s criteria predicted 16 patients to have severe pancreatitis, whereas only 8 cases turned out to be severe.  CRP estimation predicted 14 to be severe, of which, 10 patients had a severe outcome. Ranson’s criteria showed a sensitivity of 66.6%; specificity of 73.3% and accuracy of 71.4; whereas, serum CRP showed a sensitivity of 83.3; specificity of 86.6% and accuracy of 85.7%.

Conclusion: Serum CRP shows a higher prognostic sensitivity and accuracy than Ranson’s scoring system. CRP as a single parameter can be used to predict the development of complications in acute pancreatitis. It is a good early marker for the severity of acute pancreatitis.  The CRP value at the end of the first week is useful in monitoring the clinical course.

Keywords: Acute pancreatitis, Ranson’s criteria, Serum C-reactive protein,Severe acute pancreatitis

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Corresponding Author

Reeja R.

Associate Professor, Department of Pharmacology, Govt. Medical College, Kollam, India