Evaluating The Predictive Role Of C-Reactive Protein In Assessing The Severity Of Acute Pancreatitis

Abstract

Objective: To evaluate the predictive value of C-reactive protein (CRP) levels, including absolute values and interval changes at 24, 48, and 72 hours, in assessing the severity of acute pancreatitis (AP) according to the Revised Atlanta Classification.

Study Design: Cross-sectional observational study.

Study Duration: This study was conducted at Shaheed Mohtarma Benazir Bhutto Medical College Lyari Karachi Hospital from January 2024 to January 2025.

Methods: This study included 166 patients aged 12-60 years selected via non-probability consecutive sampling. CRP was measured at admission and 24, 48, 72 hours. Severity was stratified as mild (no organ failure/complications), moderate (transient organ failure <48 hours or local complications), or severe (persistent organ failure >48 hours). Data analysis used SPSS v21.0, with frequencies/percentages for categorical variables, means ± SD for continuous, Shapiro-Wilk for normality, Pearson’s correlation for CRP-severity associations, and chi-square tests (p<0.05 significant).

Results: The cohort had a mean age of 40 years (±5 SD), with 63.9% males (n=106). Disease severity distribution comprised mild cases at 19.9% (n=33), moderate at 51.2% (n=85), and severe at 28.9% (n=48). CRP levels increased progressively across groups: mild from 165 mg/dL to 202 mg/dL, moderate from 191 mg/dL to 263 mg/dL, and severe from 220 mg/dL to 342 mg/dL over 72 hours, achieving statistical significance at 72 hours (p=0.032). Interval changes were most pronounced in severe cases (+122 mg/dL total), compared to moderate (+72 mg/dL) and mild (+37 mg/dL).

Conclusion: CRP exhibits substantial predictive capability for AP severity, as interval changes prove equally effective as absolute values. Continuous monitoring facilitates early interventions, which may improve clinical outcomes in diverse settings.