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J Korean Soc Emerg Med > Volume 15(3); 2004 > Article
Journal of The Korean Society of Emergency Medicine 2004;15(3): 173-177.
Usefulness of C-Reactive Protein and Abdominal CT for the Prognosis of Acute Pancreatitis
Yeon Ho You, Jung Soo Park, Sung Soo Park, Jung Kyu Park, Sung Pil Chung, Seung Whan Kim, In Sool You
Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejon, Korea. emstar@naver.com
ABSTRACT
PURPOSE:
An early prediction of the prognosis is essential for proper management of acute pancreatitis. The Ranson criteria, a classic prognostic marker, are known not to provide relevant information, especially in an acute setting. The purpose of this study was to evaluate the usefulness of creactive protein (CRP) and CT scan as prognostic indicators in patients of acute pancreatitis.
METHODS:
Patients who were diagnosed with acute pancreatitis from January 2002 to December 2003 were enrolled in this study. The patients underwent abdominal CT scans, and their CT findings were classified as normal, pancreatic enlargement, peripancreatic fat infiltration, single peripancreatic fluid collection, and two or more fluid collections or retroperitoneal air. The CRP results were classified as < 0.3 mg/dL, 0.3-15 mg/dL, and > 15 mg/dL. The outcome was evaluated by using the mortality and the number of organ failures.
RESULTS:
Among the 188 enrolled patients, 6 were died. The CRP level and the CT severity index were significantly lower in the survival group. The number of organ failures was significantly higher when two or more fluid collections were found in the CT and when the CRP level was higher than 15 mg/dL. The most useful indicator to predict death was the CT-CRP determined by using a ROC curve analysis.
CONCLUSION:
This study suggests that CT-CRP may be used as a prognostic indicator of acute pancreatitis in the emergency department.
Key words: Pancreatitis, Computed tomography, C-reactive protein
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