C-Reactive Protein as a Prognostic Indicator: Navigating the Challenge of Predicting Severity and Mortality in Acute Pancreatitis

Abstract

Objective: The main goal was to evaluate the effectiveness of C-reactive protein (CRP) in assessing acute pancreatitis severity 48 hours after onset by contrasting its results with CT scans.

Methodology: This cross-sectional study, which lasted six months from May to December 2019 at the Department of General Surgery, Pakistan Institute of Medical Sciences, comprised 150 suspected cases. CT scans and serum samples were taken 48 hours after the onset of symptoms. A postgraduate trainee created reports using a standard proforma to record CT scan results and CRP levels.

Results: The average age of the patients was 45.03±10.86 years, with severe acute pancreatitis confirmed in 28.7% of cases by CT scans. CRP demonstrated notable diagnostic values: sensitivity 81.4%, specificity 92.52%, PPV 81.4%, NPV 92.52%, and an overall accuracy of 89.33%.

Conclusion: C-reactive protein (CRP), a product of interleukin-1 and interleukin-6 responses by the liver, emerges as a valuable and cost-effective biomarker. Its consistent elevation in correlation with pancreatitis severity, especially within the critical 48-hour window, suggests its potential as a reliable predictor. This study underscores CRP's diagnostic utility and accessibility, emphasizing its role in assessing acute pancreatitis severity.

Key Words: C-reactive protein, CT scan, Acute pancreatitis