Abstract

Various methods have been used to predict progress of acute pancreatitis. C-reactive protein (CRP) is a nonspecific mediator of inflammation produced by hepatocytes in liver and is induced by cytokine (particularly IL-6) stimulation. Current accepted gold standard for assessing severity of acute pancreatitis is contrast enhanced CT imaging (CECT). Objective: To study correlation between CRP and CECT Severity Index in assessing severity of acute pancreatitis Methods: Present diagnostic-evaluation study was conducted over two years among 25 cases of acute pancreatitis. Proper history, physical examination and appropriate investigations were done for diagnosis of acute pancreatitis. CRP levels were estimated at admission, 48hrs, 96hrs and at first week. CECT Severity Index was assessed at 7th day and was graded as per standard guidelines. Results: Males were affected than females. Most common age group affected was 31-40 (44%). Mean age of presentation was 42.44± 12.1. Most common cause of acute pancreatitis was alcoholism (84%). Most patients were in mild pancreatitis group as per CT severity index. There was positive correlation between CRP values at admission, 48hrs, and 96hrs & at 1st week with CT Severity Index. Sensitivity of CRP in predicting severity of acute pancreatitis decreased from 100% at 48hrs to 50% at 96hrs. Specificity of CRP increased from 52.4% at 48hrs to 100% at 96hrs. Positive predictive value of CRP increased from 28% at 48hrs to 100% at 96hrs. There was only mild decrease (i.e. 100% to 91.3%) in Negative predictive value of CRP from 48hrs to 96hrs. Conclusion: Therefore, CRP is a very sensitive test at 48hrs and a very specific test at 96hrs.

Description