Correlation of C-Reactive Protein and Computed Tomography Severity Index in Acute Pancreatitis
Keywords:Acute pancreatitis, CT severity, C-reactive protein.
AbstractBackground: Acute pancreatitis is the inflammatory disorder which can be mild or severe. Early diagnosis and proper assessment of the disease severity have a critical role in its treatment. Objective: Determine the correlation of C-reactive protein and computed tomography severity index in acute pancreatitis. Methods: This cross-sectional study took place at department of General surgery, Pakistan Institute of Medical Sciences hospital Islamabad (PIMS), from September 2019 to February 2020. Patients of age between 15-70 years, presenting with acute severe epigastrium pain spreading to back, diagnosed as acute pancreatitis by serum amylase of 1000 units or more and either gender were included. CT scan was performed within 24 hours following presentation using axial slices of dome in diaphragm up-to pelvis by IV contrast. Slice had 3 mm of thickness in pancreas region. Various parameters of pancreatic inflammatory response, ratio of pancreatic parenchymal necrosis and additional pancreatic complications are included in the updated CT severity index measured on CT, with various points given for each parameter. A score over 5 is rated as severe pancreatitis. A blood sample was taken from each patient for CRP level. A CRP level of >10 mg/L was considered as positive. All the information was recorded via self-prepared proforma. Data analysis was done by SPSS version 20. Results: Total 67 patients of acute pancreatitis were selected for this study. Out of them, 59.7% were males and remaining were females. Most common age group was 46-60 years 43.3%. According to the pancreatic grading most of the patients presented with grade C as 29.9% and grade B as 23.9%, followed by grade D 20.95, grade E14.9% and 10.45 were normal. According to the pancreatic necrosis majority of the cases 41.8% had < 30%. There was a strong positive correlation between CT severity index and CRP level, r-value 0.346. Conclusion: C reactive protein is a reliable and non-invasive diagnostic tool for acute pancreatitis and its severity, which showed strong positive correlation with CT severity index of acute pancreatitis.
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