Articles Vol. 66 No. 2 04/03/2025

10. EVALUATION OF THE VALUE OF CRP COMPARED TO BISAP IN PREDICTING SEVERITY AND MORTALITY IN ACUTE PANCREATITIS PATIENTS

Phung Thi Quynh Hoa1,2, Diep Quang Minh3,4, Ho Tan Phat1,2
1 Cho Ray Hospital
2 Bệnh viện Chợ Rẫy
3 Becamex Binh Duong International Hospital
4 Bệnh viện Quốc tế Becamex Bình Dương
Corresponding author: pqhoadiep@gmail.com
DOI: 10.52163/yhc.v66i2.2094
33 Views
20 Downloads
Keywords
BISAP CRP acute pancreatitis severity death
Abstract

Objectives: To determine CRP levels and BISAP scores in patients with acute pancreatitis; To assess the prognostic value of CRP compared to BISAP in predicting the severity and necrosis of acute pancreatitis.

Subjects and methods: A cross-sectional study was conducted on 100 acute pancreatitis patients who were monitored and treated at Cho Ray Hospital from December 2021 to August 2022.

Results: The mean CRP levels at admission and after 48 hours were 231.6 ± 134.9 and 201.1 ± 102.0 (mg/L), respectively (p < 0.001). The BISAP score was 2.11 ± 0.96 in the severe acute pancreatitis group and 1.1 ± 0.91 in the non-severe group (p < 0.001). CRP at admission (cut-off 328 mg/L) had a prognostic value for severe acute pancreatitis and necrosis with an AUC of 0.72 (p < 0.05). CRP after 48 hours (cut-off 210 mg/L) had a prognostic value for severe acute pancreatitis with an AUC of 0.689 (p = 0.012) but no prognostic value for necrotizing acute pancreatitis. BISAP showed moderate predictive value for severe acute pancreatitis and necrotizing acute pancreatitis with AUCs of 0.771 (p < 0.001) and 0.742 (p < 0.0001), respectively.

Conclusions: CRP has value in predicting the severity of acute pancreatitis, making it suitable for rapid assessment of the patient’s condition and progression to make appropriate and timely treatment decisions.

References
[1]
Schepers N.J et al, Impact of characteristics of organ failure and infected necrosis on mortality in necrotising pancreatitis, Gut, Jun 2019, vol. 68, No. 6, pp. 1044-1051, doi: 10.1136/gutjnl-2017-314657. Google Scholar
[2]
Metri A, Bush N, Singh V.K, Predicting the severity of acute pancreatitis: Current approaches and future directions, Surgery Open Science, 2024, vol. 19, pp. 109-117. Google Scholar
[3]
Chandra S, Murali A, Bansal R, Agarwal D, Holm A, The Bedside Index for Severity in Acute Pancreatitis: a systematic review of prospective studies to determine predictive performance, Journal of community hospital internal medicine perspectives, 2017, vol. 7, No. 4, pp. 208-213. Google Scholar
[4]
Gao W, Yang H.X, Ma C.E, The Value of BISAP Score for Predicting Mortality and Severity in Acute Pancreatitis: A Systematic Review and Meta-Analysis, PLoS One, 2015, vol. 10, No. 6, pP. e0130412, doi: 10.1371/journal.pone.0130412. Google Scholar
[5]
Leppäniemi A et al, WSES guidelines for the management of severe acute pancreatitis, World journal of emergency surgery, 2019, vol. 14, No. 1, pp. 1-20. Google Scholar
[6]
Banks P.A, Bollen T.L, Dervenis C et al, Classification of acute pancreatitis 2012: revision of the Atlanta classification and definitions by international consensus, Gut, 2013, vol. 62, No. 1, pp. 102-111. Google Scholar
[7]
Karki S, Karki B, Thapa S, Shrestha R, Poudel B.N, Shrestha R, Accuracy of bedside index for severity in acute pancreatitis BISAP score in predicting outcome of acute pancreatitis, Journal of Patan Academy of Health Sciences, 2020, vol. 7, No. 2, pp. 70-76. Google Scholar
[8]
Coluoglu I, Coluoglu E, Binicier H.C, Binicier O.B, The role of the BISAP score in predicting acute pancreatitis severity according to the revised Atlanta classification: a single tertiary care unit experience from Turkey, Acta Gastro-Enterologica Belgica, 2021, vol. 84, No. 4, pp. 571-576. Google Scholar
[9]
Yigit Y, Selçok K, Can C-reactive protein increase the efficiency of the bedside index of severity in acute pancreatitis scoring system?, Cureus, 2019, vol. 11, No. 3, pp. 1-7. Google Scholar
[10]
Fujiwara J, Matsumoto S, Sekine M, Mashima H, C‐reactive protein predicts the development of walled‐off necrosis in patients with severe acute pancreatitis, JGH Open, 2021, vol. 5, No. 8, pp. 907-914. Google Scholar
[11]
Nguyễn Huyền Châu, Nghiên cứu giá trị phối hợp tỷ số PLR-NLR với BISAP trong tiên lượng bệnh nhân viêm tụy cấp ở Bệnh viện Chợ Rẫy, Luận văn bác sỹ chuyên khoa cấp II, Trường Đại học Y Dược Huế, 2019. Google Scholar
[12]
Singh V.K et al, An assessment of the severity of interstitial pancreatitis, Clinical Gastroenterology and Hepatology, 2011, vol. 9, No. 12, pp. 1098-1103. Google Scholar
[13]
Lê Thị Ngọc Sương, Nghiên cứu giá trị của phối hợp thang điểm HAP và BISAP trong đánh giá độ nặng ở bệnh nhân viêm tụy cấp,, Tạp chí Y Dược học, Trường Đại học Y Dược Huế, 2019, vol. 9, no. 1, pp. 96-100. Google Scholar