Aaron D Stirling1, Neil R Moran2, Michael E Kelly2, Paul F Ridgway2, Kevin C Conlon2. 1. Department of Surgery, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland. Electronic address: stirlina@tcd.ie. 2. Department of Surgery, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.
Abstract
BACKGROUND: Using revised Atlanta classification defined outcomes, we compare absolute values in C-reactive protein (CRP), with interval changes in CRP, for severity stratification in acute pancreatitis (AP). METHODS: A retrospective study of all first incidence AP was conducted over a 5-year period. Interval change in CRP values from admission to day 1, 2 and 3 was compared against the absolute values. Receiver-operator characteristic (ROC) curve and likelihood ratios (LRs) were used to compare ability to predict severe and mild disease. RESULTS: 337 cases of first incidence AP were included in our analysis. ROC curve analysis demonstrated the second day as the most useful time for repeat CRP measurement. A CRP interval change >90 mg/dL at 48 h (+LR 2.15, -LR 0.26) was equivalent to an absolute value of >150 mg/dL within 48 h (+LR 2.32, -LR 0.25). The optimal cut-off for absolute CRP based on new, more stringent definition of severity was >190 mg/dL (+LR 2.72, -LR 0.24). CONCLUSION: Interval change in CRP is a comparable measure to absolute CRP in the prognostication of AP severity. This study suggests a rise of >90 mg/dL from admission or an absolute value of >190 mg/dL at 48 h predicts severe disease with the greatest accuracy.
BACKGROUND: Using revised Atlanta classification defined outcomes, we compare absolute values in C-reactive protein (CRP), with interval changes in CRP, for severity stratification in acute pancreatitis (AP). METHODS: A retrospective study of all first incidence AP was conducted over a 5-year period. Interval change in CRP values from admission to day 1, 2 and 3 was compared against the absolute values. Receiver-operator characteristic (ROC) curve and likelihood ratios (LRs) were used to compare ability to predict severe and mild disease. RESULTS: 337 cases of first incidence AP were included in our analysis. ROC curve analysis demonstrated the second day as the most useful time for repeat CRP measurement. A CRP interval change >90 mg/dL at 48 h (+LR 2.15, -LR 0.26) was equivalent to an absolute value of >150 mg/dL within 48 h (+LR 2.32, -LR 0.25). The optimal cut-off for absolute CRP based on new, more stringent definition of severity was >190 mg/dL (+LR 2.72, -LR 0.24). CONCLUSION: Interval change in CRP is a comparable measure to absolute CRP in the prognostication of AP severity. This study suggests a rise of >90 mg/dL from admission or an absolute value of >190 mg/dL at 48 h predicts severe disease with the greatest accuracy.
Authors: Pedro Silva-Vaz; Ana Margarida Abrantes; Sara Morgado-Nunes; Miguel Castelo-Branco; António Gouveia; Maria Filomena Botelho; José Guilherme Tralhão Journal: Int J Mol Sci Date: 2020-06-16 Impact factor: 5.923
Authors: Maxim Avanesov; Anastassia Löser; Alla Smagarynska; Sarah Keller; Helena Guerreiro; Enver Tahir; Murat Karul; Gerhard Adam; Jin Yamamura Journal: PLoS One Date: 2018-10-25 Impact factor: 3.240