C-Reactive Protein at 24 Hours after Hospital Admission may have Relevant Prognostic Accuracy in Acute Pancreatitis

A Retrospective Cohort Study

Filipe S. Cardoso, Leonel B. Ricardo, Ana M. Oliveira, David V. Horta, Ana L. Papoila, João R. Deus, Jorge Canena

Research output: Contribution to journalArticle

4 Citations (Scopus)
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Abstract

Introduction: C-reactive protein (CRP) and Bedside Index for Severity in Acute Pancreatitis (BISAP) have been used in early risk assessment of patients with AP. Objectives: We evaluated prognostic accuracy of CRP at 24 hours after hospital admission (CRP24) for in-hospital mortality (IM) in AP individually and with BISAP. Materials and Methods: This retrospective cohort study included 134 patients with AP from a Portuguese hospital in 2009-2010. Prognostic accuracy assessment used area under receiver-operating characteristic curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: Thirteen percent of patients had severe AP, 26% developed pancreatic necrosis, and 7% died during index hospital stay. AUCs for CRP24 and BISAP individually were 0.80 (95% confidence interval (CI) 0.65-0.95) and 0.77 (95% CI 0.59-0.95), respectively. No patients with CRP24 <60 mg/l died (P = 0.027; negative predictive value 100% (95% CI 92.3-100%)). AUC for BISAP plus CRP24 was 0.81 (95% CI 0.65-0.97). Change in NRInonevents (42.4%; 95% CI, 24.9-59.9%) resulted in positive overall NRI (31.3%; 95% CI, -36.4% to 98.9%), but IDInonevents was negligible (0.004; 95% CI, -0.007 to 0.014). Conclusions: CRP24 revealed good prognostic accuracy for IM in AP; its main role may be the selection of lowest risk patients.

Original languageEnglish
Pages (from-to)198-203
Number of pages6
JournalGE Portuguese Journal of Gastroenterology
Volume22
Issue number5
DOIs
Publication statusPublished - 1 Sep 2015

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Pancreatitis
C-Reactive Protein
Cohort Studies
Retrospective Studies
Confidence Intervals
Area Under Curve
Hospital Mortality
ROC Curve
Length of Stay
Necrosis

Keywords

  • C-Reactive Protein
  • Pancreatitis
  • Predictive Value of Tests
  • Prognosis
  • Risk Factors
  • Time Factors

Cite this

@article{5927d62454af410b90106df72b0ab6aa,
title = "C-Reactive Protein at 24 Hours after Hospital Admission may have Relevant Prognostic Accuracy in Acute Pancreatitis: A Retrospective Cohort Study",
abstract = "Introduction: C-reactive protein (CRP) and Bedside Index for Severity in Acute Pancreatitis (BISAP) have been used in early risk assessment of patients with AP. Objectives: We evaluated prognostic accuracy of CRP at 24 hours after hospital admission (CRP24) for in-hospital mortality (IM) in AP individually and with BISAP. Materials and Methods: This retrospective cohort study included 134 patients with AP from a Portuguese hospital in 2009-2010. Prognostic accuracy assessment used area under receiver-operating characteristic curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: Thirteen percent of patients had severe AP, 26{\%} developed pancreatic necrosis, and 7{\%} died during index hospital stay. AUCs for CRP24 and BISAP individually were 0.80 (95{\%} confidence interval (CI) 0.65-0.95) and 0.77 (95{\%} CI 0.59-0.95), respectively. No patients with CRP24 <60 mg/l died (P = 0.027; negative predictive value 100{\%} (95{\%} CI 92.3-100{\%})). AUC for BISAP plus CRP24 was 0.81 (95{\%} CI 0.65-0.97). Change in NRInonevents (42.4{\%}; 95{\%} CI, 24.9-59.9{\%}) resulted in positive overall NRI (31.3{\%}; 95{\%} CI, -36.4{\%} to 98.9{\%}), but IDInonevents was negligible (0.004; 95{\%} CI, -0.007 to 0.014). Conclusions: CRP24 revealed good prognostic accuracy for IM in AP; its main role may be the selection of lowest risk patients.",
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author = "Cardoso, {Filipe S.} and Ricardo, {Leonel B.} and Oliveira, {Ana M.} and Horta, {David V.} and Papoila, {Ana L.} and Deus, {Jo{\~a}o R.} and Jorge Canena",
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C-Reactive Protein at 24 Hours after Hospital Admission may have Relevant Prognostic Accuracy in Acute Pancreatitis : A Retrospective Cohort Study. / Cardoso, Filipe S.; Ricardo, Leonel B.; Oliveira, Ana M.; Horta, David V.; Papoila, Ana L.; Deus, João R.; Canena, Jorge.

In: GE Portuguese Journal of Gastroenterology, Vol. 22, No. 5, 01.09.2015, p. 198-203.

Research output: Contribution to journalArticle

TY - JOUR

T1 - C-Reactive Protein at 24 Hours after Hospital Admission may have Relevant Prognostic Accuracy in Acute Pancreatitis

T2 - A Retrospective Cohort Study

AU - Cardoso, Filipe S.

AU - Ricardo, Leonel B.

AU - Oliveira, Ana M.

AU - Horta, David V.

AU - Papoila, Ana L.

AU - Deus, João R.

AU - Canena, Jorge

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Introduction: C-reactive protein (CRP) and Bedside Index for Severity in Acute Pancreatitis (BISAP) have been used in early risk assessment of patients with AP. Objectives: We evaluated prognostic accuracy of CRP at 24 hours after hospital admission (CRP24) for in-hospital mortality (IM) in AP individually and with BISAP. Materials and Methods: This retrospective cohort study included 134 patients with AP from a Portuguese hospital in 2009-2010. Prognostic accuracy assessment used area under receiver-operating characteristic curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: Thirteen percent of patients had severe AP, 26% developed pancreatic necrosis, and 7% died during index hospital stay. AUCs for CRP24 and BISAP individually were 0.80 (95% confidence interval (CI) 0.65-0.95) and 0.77 (95% CI 0.59-0.95), respectively. No patients with CRP24 <60 mg/l died (P = 0.027; negative predictive value 100% (95% CI 92.3-100%)). AUC for BISAP plus CRP24 was 0.81 (95% CI 0.65-0.97). Change in NRInonevents (42.4%; 95% CI, 24.9-59.9%) resulted in positive overall NRI (31.3%; 95% CI, -36.4% to 98.9%), but IDInonevents was negligible (0.004; 95% CI, -0.007 to 0.014). Conclusions: CRP24 revealed good prognostic accuracy for IM in AP; its main role may be the selection of lowest risk patients.

AB - Introduction: C-reactive protein (CRP) and Bedside Index for Severity in Acute Pancreatitis (BISAP) have been used in early risk assessment of patients with AP. Objectives: We evaluated prognostic accuracy of CRP at 24 hours after hospital admission (CRP24) for in-hospital mortality (IM) in AP individually and with BISAP. Materials and Methods: This retrospective cohort study included 134 patients with AP from a Portuguese hospital in 2009-2010. Prognostic accuracy assessment used area under receiver-operating characteristic curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: Thirteen percent of patients had severe AP, 26% developed pancreatic necrosis, and 7% died during index hospital stay. AUCs for CRP24 and BISAP individually were 0.80 (95% confidence interval (CI) 0.65-0.95) and 0.77 (95% CI 0.59-0.95), respectively. No patients with CRP24 <60 mg/l died (P = 0.027; negative predictive value 100% (95% CI 92.3-100%)). AUC for BISAP plus CRP24 was 0.81 (95% CI 0.65-0.97). Change in NRInonevents (42.4%; 95% CI, 24.9-59.9%) resulted in positive overall NRI (31.3%; 95% CI, -36.4% to 98.9%), but IDInonevents was negligible (0.004; 95% CI, -0.007 to 0.014). Conclusions: CRP24 revealed good prognostic accuracy for IM in AP; its main role may be the selection of lowest risk patients.

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KW - Pancreatitis

KW - Predictive Value of Tests

KW - Prognosis

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KW - Time Factors

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