C-reactive protein accurately predicts severity of acute pancreatitis in children
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In brief
In brief
This retrospective study of 59 children demonstrates that C-reactive protein measured at 48 hours post-admission is an excellent predictor of acute pancreatitis severity, with a cutoff of 107.5mg/L achieving 91% sensitivity and 89% specificity. CRP outperforms existing modified adult scoring systems in pediatric populations, offering clinicians a simple, reliable tool for early risk stratification and care optimization.
Written by the GCMD Library team from the article.
Introduction
Predicting severity of acute pancreatitis enables optimization of care, reducing morbidity and length of stay. Modified adult scoring systems have not been able to adequately predict severity in children.
Methods
This was a retrospective study of children presenting with a first episode of acute pancreatitis from 2002-2020 in a single tertiary paediatric surgical centre. Serum markers including CRP at 48 hours of admission were analysed. Promising biomarkers underwent ROC (Receiver Operating Curve) analysis, and these were compared to the modified Glasgow Pancreas Score. An AUC (Area Under Curve) >0.90 was taken as an excellent predictor of severity.
Results
Data of 59 children were analysed, median age 13 years. 22 patients (37%) had a severe episode. ROC analysis demonstrated CRP as the best predictor of severity giving an AUC of 0.92. Optimum cut off value for CRP was 107.5mg/L (p108mg/L within 48 hours of admission can be used to predict severity of acute pancreatitis in children with greater accuracy than current scoring systems.
Type of Study
Diagnostic Test.
Level of Evidence
Level I.