Retrospective evaluation of radiologic scoring and CRP / albumin index in terms of the mortality and morbidity of the disease in acute pancreatitis

Introduction and Aim: Since AP is a life-threatening disease, it is critical to determine the severity of the disease, prognostic follow-up, and predict morbidity and mortality. Initiation of the most appropriate emergency treatment with an accurate estimation of severity at the time of application reduces the risk of death and the costs of the health system. Materials and Methods: A total of 632 patients with a diagnosis of AP were included in the study. The data was obtained from Nucleus, the automation system of our hospital. In the study, Computed Tomography Severity Index (CTSI score) scoring was made in accordance with the Computer Tomography (CT) results taken after the diagnosis of AP. The duration of hospitalization, complication development, hospitalization in the intensive care unit, number of attacks, death rate, and necessity of invasive procedure were recorded. C-reactive protein (CRP) (mg/l), albumin (Alb) (mg/dl), CRP/albumin index and CRP, Albumin, CRP/Alb ratio measured at 48th hour were calculated at the first hospitalization. The patients were divided into groups as mild, moderate and severe according to the severity of AP, the CRP/Alb index was calculated separately for each group. The CRP/Alb index was evaluated in terms of predicting the morbidity and mortality of the disease. Results: In this retrospective study conducted with patients diagnosed with AP in our hospital, it was found that the CRP/Alb index was correlated with the radiological scoring system CTSI in predicting the severity of the disease. In our study, the CRP/Alb ratio was found to be significantly higher (p < 0.05) in moderate and severe AP than mild AP both at first admission and at 48 hours. In predicting the development of complications, both the first hospitalization and 48th hour levels were found to be significantly higher (p < 0.05) in mild and severe AP patients with complications than those without complications. In moderate pancreatitis, 48th hour CRP/Alb level was found to be significantly higher (p < 0.05) in predicting complications. The 48th hour CRP/Alb level was found to be significantly higher (p < 0.05) in mild and moderate pancreatitis in predicting admission to the intensive care unit. In terms of predicting the hospitalization process, it was found that it was >7 days in patients with mild and moderate AP and those with a high 48th hour CRP/Alb ratio. The CRP/Alb ratio was found to be insufficient to predict death and necessitate invasive procedures in mild, moderate and severe AP (fitting CTSI scores). Conclusion: The fact that the CRP/Albumin ratio is fast, easy to do, and cheap supports that it is a helpful parameter in predicting the severity, morbidity and mortality of AP. More comprehensive studies to be done may guide the treatment decision and predict the prognosis. Keywords: Acute Pancreatitis, CTSI score, CRP/Alb index, Mortality, Morbidity