scholarly journals APACHE II score, C-reactive protein and Marshall score in acute pancreatitis. Association with admission at critical care unit. A cohort study

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e321-e322
Author(s):  
H. Losada Morales ◽  
A. Troncoso Trujillo ◽  
L. Burgos San Juan ◽  
J. Silva Abarca ◽  
L. Acencio Barrientos ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Critical Care ◽  
Cohort Study ◽  
Critical Care Unit ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Marshall Score

scholarly journals Neutrophil-Lymphocyte Count Ratio Better Predict Prognosis than Conventional Markers in Critical Patients? A Multiple-Centered Retrospective Cohort Study

2020 ◽  
Author(s):  
Tao Zhou ◽  
Nan Zheng ◽  
Xiang Li ◽  
Dongmei Zhu ◽  
YI HAN
Keyword(s):  
Cohort Study ◽  
Critical Illness ◽  
Retrospective Cohort Study ◽  
Lymphocyte Count ◽  
Inflammatory Markers ◽  
Retrospective Cohort ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Reactive Protein

Abstract Background: Neutrophil-lymphocyte count ratio (NLCR) has been reported as better indicator of bacteremia than procalcitonin (PCT), and better predictor of mortality than C-reactive protein (CRP) in various medical conditions. However, large controversy remains upon this topic. We compared the efficiency of NLCR with conventional inflammatory markers in predicting the prognosis of critical illness. Methods: We performed a multiple-centered retrospective cohort study consisting of 536 ICU patients with outcomes of survival, 28- and 7-day mortality. NLCR was compared with conventional inflammatory markers such as PCT, C-reactive protein (CRP), serum lactate (LAC), white blood cell, neutrophil and severity score APACHE II (Acute Physiology and Chronic Health Evaluation II) to evaluate the predictive value on outcomes of critical illness. Then receiver operating characteristics (ROC) curves were constructed to assess and compare each marker’s sensitivity and specificity respectively. Results: NLCR values were not differential among survival and mortality groups. Meanwhile remarkable differences were observed upon APACHE II score, CRP, PCT and LAC levels among survival and death groups. ROC analysis revealed that NLCR was not competent to predict prognosis of critical illness. The AUROCs of conventional markers such as CRP, PCT, LAC and APACHE II score were more significant in predicting 28- and 7-day mortality. Conclusions: NLCR is not competent and less reliable than conventional markers CRP, PCT, LAC and APACHE II score in assessing severity and in predicting outcomes of critical illness.

scholarly journals Neutrophil-lymphocyte count ratio better predict prognosis than conventional markers in critical patients? A multiple-centered retrospective cohort study

2020 ◽  
Author(s):  
Tao Zhou ◽  
Nan Zheng ◽  
Xiang Li ◽  
Dongmei Zhu ◽  
Yi Han
Keyword(s):  
Cohort Study ◽  
Critical Illness ◽  
Retrospective Cohort Study ◽  
Lymphocyte Count ◽  
Inflammatory Markers ◽  
Retrospective Cohort ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Reactive Protein

Abstract Background: Neutrophil-lymphocyte count ratio (NLCR) has been reported as better indicator of bacteremia than procalcitonin (PCT), and better predictor of mortality than C-reactive protein (CRP) in various medical conditions. However, large controversy remains upon this topic. We compared the efficiency of NLCR with conventional inflammatory markers in predicting the prognosis of critical illness. Methods: We performed a multiple-centered retrospective cohort study consisting of 536 ICU patients with outcomes of survival, 28- and 7-day mortality. NLCR was compared with conventional inflammatory markers such as PCT, C-reactive protein (CRP), serum lactate (LAC), white blood cell, neutrophil and severity score APACHE II (Acute Physiology and Chronic Health Evaluation II) to evaluate the predictive value on outcomes of critical illness. Then receiver operating characteristics (ROC) curves were constructed to assess and compare each marker’s sensitivity and specificity respectively. Results: NLCR values were not differential among survival and mortality groups. Meanwhile remarkable differences were observed upon APACHE II score, CRP, PCT and LAC levels among survival and death groups. ROC analysis revealed that NLCR was not competent to predict prognosis of critical illness. The AUROCs of conventional markers such as CRP, PCT, LAC and APACHE II score were more significant in predicting 28- and 7-day mortality. Conclusions: NLCR is not competent and less reliable than conventional markers CRP, PCT, LAC and APACHE II score in assessing severity and in predicting outcomes of critical illness.

scholarly journals Serum Profiles of C-Reactive Protein, Interleukin-8, and Tumor Necrosis Factor- in Patients with Acute Pancreatitis

HPB Surgery ◽  
2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Michael K. Digalakis ◽  
Iraklis E. Katsoulis ◽  
Kalliopi Biliri ◽  
Katina Themeli-Digalaki
Keyword(s):  
Acute Pancreatitis ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Mild Disease ◽  
Reactive Protein ◽  
Significant Difference ◽  
Necrosis Factor

Background-Aims. Early prediction of the severity of acute pancreatitis would lead to prompt intensive treatment resulting in improvement of the outcome. The present study investigated the use of C-reactive protein (CRP), interleukin IL-8 and tumor necrosis factor- (TNF-) as prognosticators of the severity of the disease. Methods. Twenty-six patients with acute pancreatitis were studied. Patients with APACHE II score of 9 or more formed the severe group, while the mild group consisted of patients with APACHE II score of less than 9. Serum samples for measurement of CRP, IL-8 and TNF- were collected on the day of admission and additionally on the 2nd, 3rd and 7th days. Results. Significantly higher levels of IL-8 were found in patients with severe acute pancreatitis compared to those with mild disease especially at the 2nd and 3rd days ( and , resp.). No significant difference for CRP and TNF- was observed between the two groups. The optimal cut-offs for IL-8 in order to discriminate severe from mild disease at the 2nd and 3rd days were 25.4 pg/mL and 14.5 pg/mL, respectively. Conclusions. IL-8 in early phase of acute pancreatitis is superior marker compared to CRP and TNF- for distinguishing patients with severe disease.

scholarly journals C-reactive protein concentration as a risk predictor of mortality in intensive care unit: a multicenter, prospective, observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rong Qu ◽  
Linhui Hu ◽  
Yun Ling ◽  
Yating Hou ◽  
Heng Fang ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Inflammatory Markers ◽  
Prospective Observational Study ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Icu Mortality ◽  
Reactive Protein ◽  
Risk Reclassification ◽  
Multicenter Prospective Observational Study

Abstract Background It is not clear whether there are valuable inflammatory markers for prognosis judgment in the intensive care unit (ICU). We therefore conducted a multicenter, prospective, observational study to evaluate the prognostic role of inflammatory markers. Methods The clinical and laboratory data of patients at admission, including C-reactive protein (CRP), were collected in four general ICUs from September 1, 2018, to August 1, 2019. Multivariate logistic regression was used to identify factors independently associated with nonsurvival. The area under the receiver operating characteristic curve (AUC-ROC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to evaluate the effect size of different factors in predicting mortality during ICU stay. 3 -knots were used to assess whether alternative cut points for these biomarkers were more appropriate. Results A total of 813 patients were recruited, among whom 121 patients (14.88%) died during the ICU stay. The AUC-ROC values of PCT and CRP for discriminating ICU mortality were 0.696 (95% confidence interval [CI], 0.650–0.743) and 0.684 (95% CI, 0.633–0.735), respectively. In the multivariable analysis, only APACHE II score (odds ratio, 1.166; 95% CI, 1.129–1.203; P = 0.000) and CRP concentration > 62.8 mg/L (odds ratio, 2.145; 95% CI, 1.343–3.427; P = 0.001), were significantly associated with an increased risk of ICU mortality. Moreover, the combination of APACHE II score and CRP > 62.8 mg/L significantly improved risk reclassification over the APACHE II score alone, with NRI (0.556) and IDI (0.013). Restricted cubic spline analysis confirmed that CRP concentration > 62.8 mg/L was the optimal cut-off value for differentiating between surviving and nonsurviving patients. Conclusion CRP markedly improved risk reclassification for prognosis prediction.

scholarly journals Clinical Profile and Outcome of Patients with Severe Acute Pancreatitis

2020 ◽  
Vol 9 (3) ◽  
pp. 8-11
Author(s):  
Rishabh Sehgal ◽  
Inder Pal Singh ◽  
Jyotisterna Mittal
Keyword(s):  
Acute Pancreatitis ◽  
Alcohol Consumption ◽  
Severe Acute Pancreatitis ◽  
Sofa Score ◽  
Clinical Profile ◽  
Etiological Factor ◽  
Clinical Severity ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Marshall Score

Background: Acute pancreatitis (AP) is an acute inflammatory condition of the pancreas leading to pancreatic autodigestion. The present study was conducted to study the clinical profile and outcome of patients with severe acute pancreatitis. Subjects & Methods: The study was conducted on 40 patients of acute pancreatitis. Clinical profile including history, examination findings, etiology of pancreatitis, clinical severity (according to Modified Marshall Score, BISAP score, APACHE II, HAPS score, SOFA score) was recorded. Results: Severe Acute Pancreatitis (SAP) among patients. Majority of the patients i.e. 22 (55%) had alcohol consumption as etiological factor causing SAP followed by biliary 10 (25%) & idiopathic 5 (12.5%). Hypertriglyceridemia and drug-induced (herbal medication) pancreatitis was present in 1 (2.5%) patient each. Out of all 1 (2.5%), patients had a history of both alcohol consumption and the presence of gallstone as an etiological factor. 22 patients (55%) out of 40 patients only conservative management was used while 18(45%) patients underwent USG guided percutaneous drainage was done. Out of these 18 patients, 3(7.5%) patients required Laparoscopic Necrosectomy & 2(5%) patients required open necrosectomy in addition to ultrasound-guided PCD. Patients who improved had a mean BISAP SCORE of 2.15   0.54, Modified Marshall score of 3.65    1.44, APACHE II score of 9.77  4.45, SOFA score 5.54  2.49, RANSON’s score 3.85   1.80 and HAP score of 0.65   0.63. Conclusion: Most common   etiology of severe acute pancreatitis is alcohol followed by biliary etiology. Out of severity scores (BISAP, APACHE-II, SOFA, HAPS), only BISAP score ≥3 is predictive of poor outcome in patients with severe acute pancreatitis.

Sign in / Sign up

Export Citation Format

Share Document