Association of Serum C-Reactive Protein Level and Treatment Duration in Acute Cholecystitis Patients Treated Conservatively.

Selahattin Vural,Ismail Aydin,Tugrul Kesicioglu

doi:10.7759/cureus.22146

Abstract

Background: Acute cholecystitis (AC) is one of the most common gastrointestinal diseases that require hospitalization and surgical treatment. The treatment of the disease depends upon the severity of the disease and the patients’ medical status.Objective: In this study, we aimed to investigate if there is an association between the serum C-reactive protein (CRP) value and treatment response and the duration and length of hospital stay in AC patients who are treated conservatively.Methodology: The medical records of all patients with the diagnosis of AC who were treated with conservative management were included in the study. The demographic and laboratory data including CRP level at first admission to hospital, length of hospital stay, and complications during the conservative treatment were obtained from the patients’ records. Patients were divided into two groups according to the treatment response and length of hospital stay. Group 1 patients were defined as patients who responded to the medical treatment in less than three days, and Group 2 patients were defined as patients who did not respond to the medical treatment in three days and stayed at the hospital for more than three days.Results: We identified 101 patients with AC treated medically. Mean age (51.3 ± 16.3, 59.5 ± 15.7; p = 0.013), total leukocyte count (11.8 ± 4.4, 8.2 ± 2.8; p = 0.0005), and CRP value (19.3 ± 13.9, 9.6 ± 5.2; p = 0.0003) were higher in Group 2 compared to Group 1. Correlation analyses demonstrated a significant positive association between the length of hospital stay, total leukocyte count (r = 0.35; p = 0.0002), and CRP value (r = 0.59; p = 0.0004).Conclusion: We found that CRP level is associated with treatment duration and hospital stay in AC patients. However, large-scale, prospective further studies are needed to confirm our results and to determine whether CRP levels can be used to discriminate which patient would benefit from medical treatment.

Highlights

Acute cholecystitis (AC) defined by right upper quadrant pain, presence of Murphy’s sign, fever, elevated white blood cell count (WBC), and C-reactive protein (CRP) is one of the most common gastrointestinal diseases that require hospitalization and surgical treatment [1]
Large-scale, prospective further studies are needed to confirm our results and to determine whether CRP levels can be used to discriminate which patient would benefit from medical treatment
A total of 108 patients diagnosed with cholecystitis at first hospital admission and treated with conservative treatment during the study period were included in the study

Summary

Introduction

Acute cholecystitis (AC) defined by right upper quadrant pain, presence of Murphy’s sign, fever, elevated white blood cell count (WBC), and C-reactive protein (CRP) is one of the most common gastrointestinal diseases that require hospitalization and surgical treatment [1]. The treatment of AC depends on the severity of the disease and the patient’s general status [3]. CRP is a nonspecific acute-phase reactant protein synthesized in the liver, which is used as a systemic marker for inflammation. It correlates with the severity of infection and inflammation in most of the acute inflammatory diseases [6]. Acute cholecystitis (AC) is one of the most common gastrointestinal diseases that require hospitalization and surgical treatment. The treatment of the disease depends upon the severity of the disease and the patients’ medical status

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Results

Discussion

Conclusion