Erythrocyte sedimentation rate and C-reactive protein for the prediction of severity of acute pancreatitis.
OBJECTIVE
To investigate the performance of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) for predicting severe acute pancreatitis (AP).


METHODS
Fifty patients with AP were prospectively enrolled. Erythrocyte sedimentation rate and CRP were measured at admission and every 12 hours for 48 hours after admission.


RESULTS
The patients' mean age was 50 ± 2.2 years, 64% were male, and 30% developed severe AP. Patients with severe AP had higher levels of ESR (77 ± 4.7 vs 50 ± 4.8 mm/h; P = 0.002) and CRP (218 ± 30.7 vs 97 ± 12.1 mg/L; P <0.001) at 36 hours after admission compared with those with mild AP. Erythrocyte sedimentation rates of 60 mm/h or greater predict severe AP at 36 hours with a sensitivity, specificity, and positive and negative predictive values of 86%, 57%, and 48% and 90%, whereas CRP of 150 mg/L or greater provided the results of 86%, 87%, and 75% and 93%, respectively. Elevation of either ESR or CRP at 24 hours increased the sensitivity and negative predictive value to 100%, and elevation of both ESR and CRP increased the specificity and PPV to 100%.


CONCLUSIONS
Erythrocyte sedimentation rate can predict severe AP with a slightly inferior performance to CRP. Combined ESR and CRP at 24 hours can predict severe AP accurately.
Pongprasobchai
Supot
S
Division of Gastroenterology, Department of Internal Medicine, Siriraj Hospital, Bangkok, Thailand. tespb@mahidol.ac.th
Jianjaroonwong
Voravut
V
Charatcharoenwitthaya
Phunchai
P
Komoltri
Chulaluk
C
Tanwandee
Tawesak
T
Leelakusolvong
Somchai
S
Pausawasdi
Nonthalee
N
Srikureja
Wichit
W
Chainuvati
Siwaporn
S
Prachayakul
Varayu
V
Manatsathit
Sathaporn
S
Kachintorn
Udom
U
D000208:Acute Disease; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
D002097:C-Reactive Protein