COMPARATIVE STUDY OF SERUM CRP LEVELS VS APACHE –II SCORING SYSTEM IN DETERMINING SYSTEM THE SEVERITY OF ACUTE PANCREATITIS

Malik Shahnaz, Snober Malik, Amat us Sami*, Sheeba Altaf, Naveed Bashir

ABSTRACT

Background: Acute pancreatitis (AP) is a common digestive disease and the most frequent disorder of the pancreas. In third world settings, a simple scoring system predicting severity and outcome can help in improving outcome of these patient. In this regard a study was conducted to determine whether APACHE or CRP will help in developing a better scoring system for predicting outcome and severity. Results: On comparing serum CRP level > 150 mg/L with an APACHE II score of > 8, to predict a severe attack, it was seen that the former had a higher sensitivity, negative predictive value and overall accuracy compared to the latter. Again it was seen that APACHE II score had a higher specificity and positive predictive value as compared to serum CRP. However these differences were marginal, with an overall almost similar accuracy (CRP – 82 %; APACHE II – 80 %), but serum CRP scores over APACHE II in being less cumbersome, less complicated and highly cost effective. Conclusion: Since improved outcome in the severe form of AP is based on early identification of disease severity and subsequent focused management of these high-risk patients, we advocate the use of serum CRP as a routine test in patients of acute pancreatitis, to predict a severe attack of acute pancreatitis early in the course of disease and thus decrease overall mortality and burden of disease.

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