C-REACTIVE PROTEIN AS A MARKER OF CLINICAL AND LABORATORY REMISSION IN PATIENTS WITH ACUTE NECROTIZING PANCREATITIS.

Abstract

The aim: To estimate the role of C-reactive protein levels as a marker of clinical and laboratory remission in patients with acute necrotizing pancreatitis. Materials and methods: A single-center retrospective non-randomized study of 68 patients (37 (54%) men, 31 (46%) women) was carried out in the period from September 2019 to October 2020. The patients were divided into two groups: group 1 included 9 (13.2%) patients rehospitalized within a month of observation after being discharged from hospital with improvement, group 2 consisted of 59 (86.8%) patients not readmitted within the observation period. A standard package of Microsoft Excel, program MedStat v.5.2, W-test Wilcoxon and the Fisher transform was used to record, calculate and compare data. Results: Patients in groups 1 and 2 did not statistically differ in age (p = 0.727), gender (p = 0.202), body mass index (BMI) (p = 0.447), length of hospital stay (p = 0.913), volume of pancreatic lesion according to СTSI (p = 0.313) and severity of disease (p = 0.205). Incidence of pancreatic necrosis infection was 88.8% (p = 0.007) in group 1 versus 35.6% in group 2. In the group of rehospitalized patients, the level of C-reactive protein upon discharge was significantly higher (Me ± m 80.8± 9.734 (66) -88), CI 95%) compared with the patients from the group without readmission (Me ± m 21.36± 2.285 (16.1-31.1) CI 95%) p <0.001. As the "critical" CRP level for group 1, indicating readmission for infectious complications of AP, was chosen the value of the left limit of 95% CI (confidence interval), which made up ≥64.5 mg / ml. Conclusions: According to the results of our study, the risk of readmission in patients with CRP level ≥64.5 mg / L prior to being discharged exceeded 41 times the risk of readmission in those with lower CRP values (RR 41.5 ± 1.008 (95% CI 5.75-299, p = 0.04)). For each patient with CRP levels ≥64.5 mg / L, the risk of readmission within the first month after being discharged was 71% (95% CI 40.7-88.6, p = 0.03).