C-reactive protein with sequential organ failure assessment score: Valuable parameters in managing acute pancreatitis

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From: Tropical Journal of Medical Research(Vol. 17, Issue 2)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Report
Length: 2,123 words
Lexile Measure: 1540L

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Byline: Mohit. Bhatia, Daksha. Nirhale, Virender. Athavale, Murtuza. Calcuttawala, Anirudha. Kale, Manashree. Sankhe

Introduction: Acute Pancreatitis (AP) is an acute inflammation of the pancreas and the clinical evolution is frequently unpredictable. Multiple scoring systems have been developed to discriminate between patients with mild acute pancreatitis and those at high risk for developing severe pancreatitis. The assessment of the severity of pancreatitis is important for the proper management of this challenging disease. A highly accurate system that could predict the severity and identify the local extent and complications of a serious inflammation is beneficial for patient outcome. Aims and Objectives: The aim is to study the role of the C-Reactive Protein (CRP) in assessing the severity of acute pancreatitis, to evaluate the correlation between the CRP levels and response to the treatment, and to correlate between the serum CRP levels and increased risk of organ failure. Study Design: A Prospective study. Patients and Methods: Fifty patients with a clinical and laboratory diagnosis of acute pancreatitis, more than 65 years of age, were excluded from the study along with patients having an immunocompromised status or with other existing inflammatory conditions. Main Outcome Measures: Serum CRP levels were estimated at the time of admission (48 hours from the onset of symptoms) and were recorded on the third, fifth, seventh, and fourteenth days, and the patients were assessed by using the Sequential organ failure assessment (SOFA) scoring system. Results: Twenty-three patients were in the age group of 31-45 years and 36 patients (72%) were alcoholic. Ten patients had CRP levels of more than 50 mg/L. The mean CRP level at the time of admission was 36.45 mg/L. Thirty-nine patients (78%) had a SOFA score in the 0-3 range. Nineteen patients had a complicated course, with two deaths, in or study. A strong association was noted between the CRP levels and SOFA. Conclusion: The CRP levels at admission can help in predicting the outcome of the disease when used along SOFA.

Introduction

Acute Pancreatitis (AP) is highly variable in clinical presentation and severity. In a majority of patients, the course is mild and self-limiting, but in 20% of the patients it may become fulminant and progress to multisystem organ failure and death. [sup][1] One of the main problems in treating patients with pancreatitis has been the lack of reliable methods for detecting the complicated course of the disease and this has often led to a delay in giving the vital adequate treatment. [sup][2]

The severity scoring system of acute physiology and chronic health evaluation (APACHE II) was applied by Larvin et al ., in the setting of acute pancreatitis, and it was demonstrated that those with scores higher than seven were likely to have severe disease. [sup][3]

Staging the severity of acute pancreatitis based on clinical parameters has limited the specificity and sensitivity for the prediction of adverse events. Already from the decade of 1980s, staging using the serum criteria was employed.

C-reactive protein was discovered in 1930, by Tillett and Francis. [sup][4] The precise...

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Gale Document Number: GALE|A383764099