Use of the C-Reactive Protein (CRP)/Albumin Ratio as a Severity Tool in Acute Pancreatitis: Systematic Review
Acute pancreatitis is one of the most common conditions with high rates of morbidity and mortality. Different scoring systems are used to gauge the severity of this condition, which, in turn, estimates the complications and mortality rates. With the ever-evolving use of the acute-phase reactant prot...
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| Published in: | Curēus (Palo Alto, CA) Vol. 14; no. 9; p. e29243 |
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Cureus Inc
16-09-2022
Cureus |
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| Abstract | Acute pancreatitis is one of the most common conditions with high rates of morbidity and mortality. Different scoring systems are used to gauge the severity of this condition, which, in turn, estimates the complications and mortality rates. With the ever-evolving use of the acute-phase reactant protein, C-reactive protein (CRP), and an abundant circulating protein in plasma, albumin, in daily practice, this study aimed to assess the ratio of CRP and albumin for assessing the severity of acute pancreatitis. A systematic review of the literature was performed using the keywords CRP albumin ratio and acute pancreatitis in the PubMed and Cochrane databases. Studies reporting the use of the ratio of CRP and albumin in acute pancreatitis as well as the outcomes were included in this analysis. The quality of studies was assessed using the MINORS (methodological index for non-randomized studies) assessment tool. In our review, across these three studies, 956 patients with acute pancreatitis were identified and enrolled in studies that examined the relationship between the CRP/Albumin ratio and the severity of acute pancreatitis. Overall, a positive correlation was found between the CRP/albumin ratio at admission and the development of subsequent severe acute pancreatitis, increased hospital length of stay, and the higher rate of mortality in these studies. |
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| AbstractList | Acute pancreatitis is one of the most common conditions with high rates of morbidity and mortality. Different scoring systems are used to gauge the severity of this condition, which, in turn, estimates the complications and mortality rates. With the ever-evolving use of the acute-phase reactant protein, C-reactive protein (CRP), and an abundant circulating protein in plasma, albumin, in daily practice, this study aimed to assess the ratio of CRP and albumin for assessing the severity of acute pancreatitis.
A systematic review of the literature was performed using the keywords CRP albumin ratio and acute pancreatitis in the PubMed and Cochrane databases. Studies reporting the use of the ratio of CRP and albumin in acute pancreatitis as well as the outcomes were included in this analysis. The quality of studies was assessed using the MINORS (methodological index for non-randomized studies) assessment tool. In our review, across these three studies, 956 patients with acute pancreatitis were identified and enrolled in studies that examined the relationship between the CRP/Albumin ratio and the severity of acute pancreatitis.
Overall, a positive correlation was found between the CRP/albumin ratio at admission and the development of subsequent severe acute pancreatitis, increased hospital length of stay, and the higher rate of mortality in these studies. Acute pancreatitis is one of the most common conditions with high rates of morbidity and mortality. Different scoring systems are used to gauge the severity of this condition, which, in turn, estimates the complications and mortality rates. With the ever-evolving use of the acute-phase reactant protein, C-reactive protein (CRP), and an abundant circulating protein in plasma, albumin, in daily practice, this study aimed to assess the ratio of CRP and albumin for assessing the severity of acute pancreatitis. A systematic review of the literature was performed using the keywords CRP albumin ratio and acute pancreatitis in the PubMed and Cochrane databases. Studies reporting the use of the ratio of CRP and albumin in acute pancreatitis as well as the outcomes were included in this analysis. The quality of studies was assessed using the MINORS (methodological index for non-randomized studies) assessment tool. In our review, across these three studies, 956 patients with acute pancreatitis were identified and enrolled in studies that examined the relationship between the CRP/Albumin ratio and the severity of acute pancreatitis. Overall, a positive correlation was found between the CRP/albumin ratio at admission and the development of subsequent severe acute pancreatitis, increased hospital length of stay, and the higher rate of mortality in these studies. Acute pancreatitis is one of the most common conditions with high rates of morbidity and mortality. Different scoring systems are used to gauge the severity of this condition, which, in turn, estimates the complications and mortality rates. With the ever-evolving use of the acute-phase reactant protein, C-reactive protein (CRP), and an abundant circulating protein in plasma, albumin, in daily practice, this study aimed to assess the ratio of CRP and albumin for assessing the severity of acute pancreatitis.A systematic review of the literature was performed using the keywords CRP albumin ratio and acute pancreatitis in the PubMed and Cochrane databases. Studies reporting the use of the ratio of CRP and albumin in acute pancreatitis as well as the outcomes were included in this analysis. The quality of studies was assessed using the MINORS (methodological index for non-randomized studies) assessment tool. In our review, across these three studies, 956 patients with acute pancreatitis were identified and enrolled in studies that examined the relationship between the CRP/Albumin ratio and the severity of acute pancreatitis.Overall, a positive correlation was found between the CRP/albumin ratio at admission and the development of subsequent severe acute pancreatitis, increased hospital length of stay, and the higher rate of mortality in these studies. Acute pancreatitis is one of the most common conditions with high rates of morbidity and mortality. Different scoring systems are used to gauge the severity of this condition, which, in turn, estimates the complications and mortality rates. With the ever-evolving use of the acute-phase reactant protein, C-reactive protein (CRP), and an abundant circulating protein in plasma, albumin, in daily practice, this study aimed to assess the ratio of CRP and albumin for assessing the severity of acute pancreatitis. A systematic review of the literature was performed using the keywords CRP albumin ratio and acute pancreatitis in the PubMed and Cochrane databases. Studies reporting the use of the ratio of CRP and albumin in acute pancreatitis as well as the outcomes were included in this analysis. The quality of studies was assessed using the MINORS (methodological index for non-randomized studies) assessment tool. In our review, across these three studies, 956 patients with acute pancreatitis were identified and enrolled in studies that examined the relationship between the CRP/Albumin ratio and the severity of acute pancreatitis. Overall, a positive correlation was found between the CRP/albumin ratio at admission and the development of subsequent severe acute pancreatitis, increased hospital length of stay, and the higher rate of mortality in these studies.Acute pancreatitis is one of the most common conditions with high rates of morbidity and mortality. Different scoring systems are used to gauge the severity of this condition, which, in turn, estimates the complications and mortality rates. With the ever-evolving use of the acute-phase reactant protein, C-reactive protein (CRP), and an abundant circulating protein in plasma, albumin, in daily practice, this study aimed to assess the ratio of CRP and albumin for assessing the severity of acute pancreatitis. A systematic review of the literature was performed using the keywords CRP albumin ratio and acute pancreatitis in the PubMed and Cochrane databases. Studies reporting the use of the ratio of CRP and albumin in acute pancreatitis as well as the outcomes were included in this analysis. The quality of studies was assessed using the MINORS (methodological index for non-randomized studies) assessment tool. In our review, across these three studies, 956 patients with acute pancreatitis were identified and enrolled in studies that examined the relationship between the CRP/Albumin ratio and the severity of acute pancreatitis. Overall, a positive correlation was found between the CRP/albumin ratio at admission and the development of subsequent severe acute pancreatitis, increased hospital length of stay, and the higher rate of mortality in these studies. |
| Author | Khurshid, Sadaf Tarar, Muhammad Yasir Muhammad, Karim Tumeh, Haitham Choo, Xin Yin Khalid, Aizaz |
| AuthorAffiliation | 4 Gynecology, University of Lahore Teaching Hospital, Lahore, PAK 2 General Surgery, St Richards Hospital, Chichester, GBR 1 General Surgery, Tameside and Glossop Integrated Care NHS Foundation Trust, Manchester, GBR 3 Trauma and Orthopaedics, Blackpool Victoria Hospital, Blackpool, GBR |
| AuthorAffiliation_xml | – name: 1 General Surgery, Tameside and Glossop Integrated Care NHS Foundation Trust, Manchester, GBR – name: 3 Trauma and Orthopaedics, Blackpool Victoria Hospital, Blackpool, GBR – name: 4 Gynecology, University of Lahore Teaching Hospital, Lahore, PAK – name: 2 General Surgery, St Richards Hospital, Chichester, GBR |
| Author_xml | – sequence: 1 givenname: Muhammad Yasir surname: Tarar fullname: Tarar, Muhammad Yasir organization: General Surgery, Tameside and Glossop Integrated Care NHS Foundation Trust, Manchester, GBR – sequence: 2 givenname: Aizaz surname: Khalid fullname: Khalid, Aizaz organization: General Surgery, St Richards Hospital, Chichester, GBR – sequence: 3 givenname: Xin Yin surname: Choo fullname: Choo, Xin Yin organization: Trauma and Orthopaedics, Blackpool Victoria Hospital, Blackpool, GBR – sequence: 4 givenname: Sadaf surname: Khurshid fullname: Khurshid, Sadaf organization: Gynecology, University of Lahore Teaching Hospital, Lahore, PAK – sequence: 5 givenname: Haitham surname: Tumeh fullname: Tumeh, Haitham organization: General Surgery, Tameside and Glossop Integrated Care NHS Foundation Trust, Manchester, GBR – sequence: 6 givenname: Karim surname: Muhammad fullname: Muhammad, Karim organization: General Surgery, Tameside and Glossop Integrated Care NHS Foundation Trust, Manchester, GBR |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36262941$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_7759_cureus_51170 crossref_primary_10_17941_agd_1348965 crossref_primary_10_12688_f1000research_134938_1 crossref_primary_10_12688_f1000research_134938_2 |
| Cites_doi | 10.7861/clinmedicine.9-1-30 10.1001/jama.2020.20317 10.1002/bjs.1800760224 10.1155/2017/5297143 10.1371/journal.pone.0059321 10.5505/tjtes.2018.98583 10.1186/s12893-020-00991-6 10.1038/srep10481 10.1245/s10434-015-4948-7 10.7759/cureus.6943 10.3389/fimmu.2018.00754 10.1067/msy.1998.91365 10.1245/s10434-014-4048-0 10.1016/S1499-3872(17)60007-9 10.1503/cjs.015015 10.3892/mco.2017.1527 10.1016/j.pan.2017.01.005 10.1097/01.SLA.0000055547.93484.87 10.4149/BLL_2022_020 10.1136/bmj.n71 10.1007/s00431-010-1235-2 |
| ContentType | Journal Article |
| Copyright | Copyright © 2022, Tarar et al. Copyright © 2022, Tarar et al. This work is published under https://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Copyright © 2022, Tarar et al. 2022 Tarar et al. |
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| DOI | 10.7759/cureus.29243 |
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| Keywords | severity acute pancreatitis (ap) albumin level c-reactive protein (crp) ratio |
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| References | Sproston NR (ref5) 2018; 9 Wilson C (ref6) 1989; 76 Kinoshita A (ref17) 2015; 22 Yılmaz EM (ref10) 2018; 24 Zhou T (ref18) 2015; 5 Page MJ (ref21) 2021; 372 Roberts SE (ref1) 2017; 17 Mederos MA (ref4) 2021; 325 Kunizaki M (ref19) 2018; 8 Vincent JL (ref16) 2003; 237 Hong W (ref8) 2017; 2017 Zhao Z (ref12) 2020; 20 Karabuga B (ref11) 2022; 123 Fairclough E (ref14) 2009; 9 Greenberg JA (ref2) 2016; 59 Kaplan M (ref9) 2017; 15 Venkatesh NR (ref3) 2020; 12 Braamskamp MJ (ref7) 2010; 169 Ishizuka M (ref20) 2016; 23 Pinilla JC (ref13) 1998; 124 Ranzani OT (ref15) 2013; 8 |
| References_xml | – volume: 9 year: 2009 ident: ref14 article-title: Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome publication-title: Clin Med (Lond) doi: 10.7861/clinmedicine.9-1-30 contributor: fullname: Fairclough E – volume: 325 year: 2021 ident: ref4 article-title: Acute pancreatitis: a review publication-title: JAMA doi: 10.1001/jama.2020.20317 contributor: fullname: Mederos MA – volume: 76 year: 1989 ident: ref6 article-title: C-reactive protein, antiproteases and complement factors as objective markers of severity in acute pancreatitis publication-title: Br J Surg doi: 10.1002/bjs.1800760224 contributor: fullname: Wilson C – volume: 2017 year: 2017 ident: ref8 article-title: Serum albumin is independently associated with persistent organ failure in acute pancreatitis publication-title: Can J Gastroenterol Hepatol doi: 10.1155/2017/5297143 contributor: fullname: Hong W – volume: 8 year: 2013 ident: ref15 article-title: C-reactive protein/albumin ratio predicts 90-day mortality of septic patients publication-title: PLoS One doi: 10.1371/journal.pone.0059321 contributor: fullname: Ranzani OT – volume: 24 year: 2018 ident: ref10 article-title: Significance of red blood cell distribution width and C-reactive protein/albumin levels in predicting prognosis of acute pancreatitis publication-title: Ulus Travma Acil Cerrahi Derg doi: 10.5505/tjtes.2018.98583 contributor: fullname: Yılmaz EM – volume: 20 year: 2020 ident: ref12 article-title: Prognostic value of the creatinine-albumin ratio in acute pancreatitis debridement publication-title: BMC Surg doi: 10.1186/s12893-020-00991-6 contributor: fullname: Zhao Z – volume: 5 year: 2015 ident: ref18 article-title: Ratio of C-reactive protein/albumin is an inflammatory prognostic score for predicting overall survival of patients with small-cell lung cancer publication-title: Sci Rep doi: 10.1038/srep10481 contributor: fullname: Zhou T – volume: 23 year: 2016 ident: ref20 article-title: Clinical significance of the C-reactive protein to albumin ratio for survival after surgery for colorectal cancer publication-title: Ann Surg Oncol doi: 10.1245/s10434-015-4948-7 contributor: fullname: Ishizuka M – volume: 12 year: 2020 ident: ref3 article-title: Comparison of different scoring systems in predicting the severity of acute pancreatitis: a prospective observational study publication-title: Cureus doi: 10.7759/cureus.6943 contributor: fullname: Venkatesh NR – volume: 9 year: 2018 ident: ref5 article-title: Role of C-reactive protein at sites of inflammation and infection publication-title: Front Immunol doi: 10.3389/fimmu.2018.00754 contributor: fullname: Sproston NR – volume: 124 year: 1998 ident: ref13 article-title: The C-reactive protein to prealbumin ratio correlates with the severity of multiple organ dysfunction publication-title: Surgery doi: 10.1067/msy.1998.91365 contributor: fullname: Pinilla JC – volume: 22 year: 2015 ident: ref17 article-title: The C-reactive protein/albumin ratio, a novel inflammation-based prognostic score, predicts outcomes in patients with hepatocellular carcinoma publication-title: Ann Surg Oncol doi: 10.1245/s10434-014-4048-0 contributor: fullname: Kinoshita A – volume: 15 year: 2017 ident: ref9 article-title: Predictive value of C-reactive protein/albumin ratio in acute pancreatitis publication-title: Hepatobiliary Pancreat Dis Int doi: 10.1016/S1499-3872(17)60007-9 contributor: fullname: Kaplan M – volume: 59 year: 2016 ident: ref2 article-title: Clinical practice guideline: management of acute pancreatitis publication-title: Can J Surg doi: 10.1503/cjs.015015 contributor: fullname: Greenberg JA – volume: 8 year: 2018 ident: ref19 article-title: Clinical significance of the C-reactive protein-to-albumin ratio for the prognosis of patients with esophageal squamous cell carcinoma publication-title: Mol Clin Oncol doi: 10.3892/mco.2017.1527 contributor: fullname: Kunizaki M – volume: 17 year: 2017 ident: ref1 article-title: The incidence and aetiology of acute pancreatitis across Europe publication-title: Pancreatology doi: 10.1016/j.pan.2017.01.005 contributor: fullname: Roberts SE – volume: 237 year: 2003 ident: ref16 article-title: Hypoalbuminemia in acute illness: is there a rationale for intervention? A meta-analysis of cohort studies and controlled trials publication-title: Ann Surg doi: 10.1097/01.SLA.0000055547.93484.87 contributor: fullname: Vincent JL – volume: 123 year: 2022 ident: ref11 article-title: Comparison of the predictive values of CRP, CRP/albumin, RDW, neutrophil/lymphocyte, and platelet/lymphocyte levels in determining the severity of acute pancreatitis in patients with acute pancreatitis according to the BISAP score publication-title: Bratisl Lek Listy doi: 10.4149/BLL_2022_020 contributor: fullname: Karabuga B – volume: 372 year: 2021 ident: ref21 article-title: The PRISMA 2020 statement: an updated guideline for reporting systematic reviews publication-title: BMJ doi: 10.1136/bmj.n71 contributor: fullname: Page MJ – volume: 169 year: 2010 ident: ref7 article-title: Clinical practice. Protein-losing enteropathy in children publication-title: Eur J Pediatr doi: 10.1007/s00431-010-1235-2 contributor: fullname: Braamskamp MJ |
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| Title | Use of the C-Reactive Protein (CRP)/Albumin Ratio as a Severity Tool in Acute Pancreatitis: Systematic Review |
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