Abstract:
Background: Acute pancreatitis (AP) has been defined as an “acute inflammatory process of the pancreas with variable involvement of other regional tissues or remote organ systems”. Increasing incidence of AP worldwide with 33.74 cases per 100,000 persons per year reported globally over the last few years has landed it amongst the most common gastrointestinal disorders requiring hospitalization. Objective: To determine the efficacy of C Reactive Protein (CRP), in predicting severity and outcome of Acute Pancreatitis (AP), taking CT scan findings as gold standard. Study type, settings & duration: This cross-sectional research was conducted at the Department of General Surgery (Unit III), Jinnah Postgraduate Medical Center, Karachi, from January to March 2021. Methodology: A sample of 186 patients (obtained via non-probability - consecutive sampling), presenting with acute pancreatitis (based on Revised Atlanta Classification - RAC). After taking written informed consent, patient data was recorded on a structured questionnaire (containing inquiries pertaining to basic biodata, sociodemographic details, presenting complaints, inferences obtained from disease history and clinical examination, laboratory investigation (CRP values and variations - at scheduled intervals), CT findings, and patient outcome. The data obtained was analyzed using SPSS. v. 21.0. Results: The mean age of the sample was 39 (SD ± 4) years and 119 (63.9%) were males, while the remaining 67 (36.1%) were females. A raised CRP (= 150 mg/dL) was present among 163 (87.6%) of the patients. CRP changes at 24, 48 and 72 h were synonymous with disease severity and a positive association between CRP level / CRP change (rise) and disease severity was noted (p value 0.035). Recovery was achieved during the study period among majority of the patients, however complaints such as pancreatic necrosis were reported in 24 (12.9%), abscesses in 32 (17.2%), and pseudocysts in 25 (13.4) patients. Mortality was reported in 2 cases. Conclusion: CRP has a high efficacy at predicting disease severity of acute pancreatitis. The evidence yielded has offer much needed solace from AP, which is a pressing situation, both for the patient and healthcare provider. The resources (infrastructural and financial) for CT evaluation of AP patients are often not available and thus, CRP may offer help for the much needed insight into the disease severity quickly, easily and at a lower cost.
Page(s):
125-129
DOI:
DOI not available
Published:
Journal: Pakistan Journal of Medical Research, Volume: 61, Issue: 3, Year: 2022
Keywords:
Efficacy
,
Disease severity
,
Acute Pancreatitis
,
Predictive value
,
revised atlanta classification