CRP AND ALBUMIN AS PREDICTORS OF MORTALITY IN PATIENTS WITH ACUTE PANCREATITIS
PDF (Español (España))

Keywords

Pancreatitis
CRP
serum albumin
mortality

How to Cite

Villalba Aucejo, S., Alfonzo Ramos, A., Acuña Macchi, J., & Penner Sawatzky, D. (2023). CRP AND ALBUMIN AS PREDICTORS OF MORTALITY IN PATIENTS WITH ACUTE PANCREATITIS. Discover Medicine, 2(1). https://doi.org/10.2300/dm.v2i1.3117

Abstract

Background: Acute pancreatitis is a common disease with a rising incidence in the last decades. Several markers have been used to predict its mortality, but none can predict the severity in the first hour of admission. CRP, which is used to follow up inflammation, could be an indicator, also albumin, which is related to severe inflammation and mortality. The aim of this study is to determine if albumin and CRP levels are indicators of mortality in patients with acute pancreatitis.
Methods: 310 clinical records were analyzed from the Hospital Nacional de Itaugua (2015-2017). Sociodemographic data, albumin and CRP levels at the admission, comorbidity, toxic habits and the duration of the hospitalization were taken into account.
Results: 216 (69.7%) patients were women, the average age was 47.69 ± 18.1 years and 25 (8%) had a fatal outcome. Associations were found between mortality and: male sex (P=0.004), age (P=0.006), alcohol consumption (P=0.022), arterial hypertension (P=0.025), diabetes mellitus (P=0.004) and hypoalbuminemia at the admission (P=0.008). Regarding the ROC curve, it was found that the albumin and CRP levels and the quotient CRP/albumin at the admission were acceptable predictors of mortality, being the quotient CRP/albumin the best one.
Conclusion: Albumin and CRP levels and the CRP/albumin ratio at the admission proved to be early predictors of mortality in patients with acute pancreatitis.

https://doi.org/10.2300/dm.v2i1.3117
PDF (Español (España))

References

Sandler RS, Everhart JE, Donowitz M, Adams E, Cronin K, Goodman C, et al. The burden of selected digestive diseases in the United States. Gastroenterology [Internet]. 2002;122(5):1500-11. Disponible en: http://linkinghub.elsevier.com/retrieve/pii/S0016508502749652

Lowenfels AB, Maisonneuve P, Sullivan T. The changing character of acute pancreatitis: epidemiology, etiology, and prognosis. Curr Gastroenterol Rep [Internet]. 2009;11(2):97-103. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/19281696

Tenner S, Baillie J, DeWitt J, Vege SS. American College of Gastroenterology Guideline: Management of Acute Pancreatitis. Am J Gastroenterol [Internet].2013;108(9):1400-15. Disponible en: http://www.nature.com/doifinder/10.1038/ajg.2013.218

Yadav D, Lowenfels AB. Trends in the Epidemiology of the First Attack of Acute Pancreatitis. Pancreas [Internet]. 2006;33(4):323-30. Disponible en: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00006676-200611000-00003

van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester M a, Dejong CH, et al. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010;362(16):1491-502.

Everhart JE, Ruhl CE. Burden of Digestive Diseases in the United States Part III: Liver, Biliary Tract, and Pancreas. Gastroenterology [Internet]. 2009;136(4):1134-44. Disponible en: http://dx.doi.org/10.1053/j.gastro.2009.02.038

Roberts SE, Williams JG, Meddings D, Goldacre MJ. Incidence and case fatality for acute pancreatitis in England: Geographical variation, social deprivation, alcohol consumption and aetiology - A record linkage study. Aliment Pharmacol Ther. 2008;28(7):931-41.

Gompertz M, Lara I, Fernández L, Miranda JP, Mancilla C, Watkins G, et al. Mortalidad de la pancreatitis aguda: Experiencia de 20 años en el hospital Clínico Universidad de Chile. Rev Med Chil. 2013;141(5):562-7.

Poma EM, et al. Documento de Consenso SEMICYUC 2012 . Recomendaciones para el manejo en cuidados intensivos de la pancreatitis aguda. Med Intensiva. 2014;37(3):163-79.

Gardner TB, Vege SS, Chari ST, Pearson RK, Clain JE, Topazian MD, et al. The effect of age on hospital outcomes in severe acute pancreatitis. Pancreatology [Internet]. 2008;8(3):265-70. Disponible en: http://dx.doi.org/10.1159/000134274

Zhu AJ, Shi JS, Sun XJ. Risk factors influencing mortality of patients with severe acute pancreatitis within 24 hours after admission [Internet]. Vol. 2, Hepatobiliary and Pancreatic Diseases International. 2003. p. 453-7.

Mofidi R, Duff MD, Wigmore SJ, Madhavan KK, Garden OJ, Parks RW. Association between early systemic inflammatory response, severity of multiorgan dysfunction and death in acute pancreatitis. Br J Surg. 2006;93(6):738-44.

Lytras D, Manes K, Triantopoulou C. Persistent early organ failure: defining the high-risk group of patients with severe acute pancreatitis?. Pancreas [Internet].2008;36(3):3-5. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/18362837

Kim YS, Yim HJ, Jeen YT, Lee HS, Kim JS, Chun HJ, et al. 중증 급성췌장염 사망률에 영향을 미치는 인자 분 석. 2008;25-33.

Matowicka-karna J. Markers of inflammation, activation of blood platelets and coagulation disorders in inflammatory bowel diseases. Posterpy Hig Med Dosw [Internet]. 2016;70:305-12. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/27117106

Kinoshita A, Onoda H, Imai N, Nishino H, Tajiri H. C-Reactive Protein as a Prognostic Marker in Patients with Hepatocellular Carcinoma. Hepatogastroenterology [Internet]. 2015;62(140):966-70. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/26902038

Rhodes B, Fürnrohr BG, Vyse TJ. C-reactive protein in rheumatology: biology and genetics. Nat Publ Gr [Internet]. 2011;7(5):282-9. Disponible en: http://dx.doi.org/10.1038/nrrheum.2011.37

Vos AG, Idris NS, Barth RE, Klipstein-Grobusch K, Grobbee DE. Pro-Inflammatory Markers in Relation to Cardiovascular Disease in HIV Infection: A Systematic Review. PLoS One [Internet]. 2016;11(1):1-16. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/26808540

Ates H, Duygu O, Bozkurt B, Celik HT, Ôzol D, Yldrm Z. What is the most reliable marker in the differential diagnosis of pulmonary embolism and community-acquired pneumonia?. Blood Coagul Fibrinolysis [Internet]. 2016;27(3):252-8. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/26258679

Lelubre C, Anselin S, Zouaoui Boudjeltia K, Biston P, Piagnerelli M. Interpretation of C-Reactive Protein concentrations in critically Ill patients. Biomed Res Int. 2013;2013.

Lee KJ, Kim HM, Choi JS, Kim YJ, Kim YS, Cho JH. Comparison of Predictive Systems in Severe Acute Pancreatitis According to the Revised Atlanta Classification. Pancreas. 2016;45(1):46-50.

Goh SL, De Silva RP, Dhital K, Gett RM. Is low serum albumin associated with postoperative complications in patients undergoing oesophagectomy for oesophageal malignancies?. Interact Cardiovasc Thorac Surg. 2015;20(1):107-13.

Kim HJ, Lee HW. Important predictor of mortality in patients with end-stage liver disease. Clin Mol Hepatol [Internet]. 2013;19(2):105-15. Disponible en: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3701842&tool=pmcentrez&rendertype=abstract

Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: A systematic review of the epidemiological literature. Nutr J [Internet]. 2010;9(1):69. Disponible en: http://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-9-69

Zhou T, Zhan J, Hong S, Hu Z, Fang W, Qin T, et al. Ratio of C-Reactive Protein/Albumin is an inflammatory prognostic score for predicting overall survival of patients with small-cell lung cancer. Sci Rep [Internet]. 2015;5(1):10481. Disponible en: http://www.nature.com/articles/srep10481

Ranzani OT, Zampieri FG, Forte DN, Azevedo LCP, Park M. C-Reactive Protein/Albumin Ratio Predicts 90-Day Mortality of Septic Patients. PLoS One. 2013;8(3).

Bradley EL. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg. 1993;128:586-90

Sullivan KM, Dean AG. OpenEpi:Sample Size for X-Sectional,Cohort,and Clinical Trials [Internet]. Disponible en: http://www.openepi.com/SampleSize/SSCohort.htm

Sánchez-Lozada R, Camacho-Hernández MI, Vega-Chavaje RG, Garza-Flores JH, Campos-Castillo C, Gutiérrez-Vega R. Pancreatitis aguda: experiencia de cinco años en el Hospital General de México. Gac. Méd. Mex [Internet]. 2004;141(2):123-7. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0016-38132005000200007

Surco Y, et al. Predicción precoz de severidad en pancreatitis aguda. Rev. gastroenterol. Perú [Internet]. 2012;32(3):241-50. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1022-51292012000300002

González-González JA, Castañeda-Sepúlveda R, Martínez-Vázquez MA, García-Compean D, Flores-Rendón AR, Maldonado-Garza HJ, et al. Características clínicas de la pancreatitis aguda en México. Rev Gastroenterol México [Internet]. 2012;77(4):167-73. Disponible en: https://www.sciencedirect.com/science/article/pii/S0375090612001127

Rosero Morales EDLA, Toledo Macas LA. Concentración sanguínea de nitrógeno ureico y su relación con la severidad y mortalidad por pancreatitis aguda, en pacientes que acudieron a los Hospitales Eugenio Espejo, Enrique Garcés, Pablo Arturo Suárez y Hospital Quito N°1 de la Policía de Quito, período del 01 de Enero del 2010 hasta el 31 de Diciembre del 2012. 2015. Disponible en: http://www.dspace.uce.edu.ec/handle/25000/4699

Ledesma-Heyer JP, Amaral JA. Pancreatitis aguda. Med Interna Mex. 2009;25(4):285-94.

Gómez Zuleta M, Ruiz Lobo X, Otero Regino W. Nueva escala simple y rápida para predecir la severidad de pancreatitis aguda. Rev Colomb Gastroenterol [Internet]. 2010;118-27. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-99572010000200004&lang=pt

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright (c) 2023 Santiago Villalba Aucejo, Alejandra Alfonzo Ramos, Juan Acuña Macchi, Debora Penner Sawatzky

Downloads

Download data is not yet available.