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The Prognostic Value of Different Levels of Cortisol and High-Sensitivity C-Reactive Protein in Early Acute Pancreatitis
The Prognostic Value of Different Levels of Cortisol and High-Sensitivity C-Reactive Protein in Early Acute Pancreatitis
- Source :
- The American Journal of the Medical Sciences. 363:435-443
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Acute pancreatitis (AP) ranges in severity from mild to severe with high mortality. Severe AP, similar to other critical illnesses, is associated with changes in cortisol level. Early increase of high-sensitivity C-reactive protein (hs-CRP) as an inflammatory marker could be an indicator of AP progression. We aimed to assess the level of cortisol and hs-CRP on initial diagnosis of AP and identify their prognostic value.This case-control study included patients with AP and a control group of healthy subjects. Laboratory tests such as liver profile, kidney functions, blood picture, lactate dehydrogenase, blood glucose, and lipogram were evaluated, the severity of AP was determined, the duration of hospitalization, complications, and outcomes were identified, and the serum levels of cortisol and hs-CRP were assessed.There were 90 patients with AP and 60 controls with a higher percent of females in both groups. Serum cortisol and hs-CRP were significantly higher in AP relative to controls and were higher in severe AP relative to mild AP. Significant positive correlation was present between high cortisol and severity of AP (r = 0.520 and p0.001) and negatively with pancreatic necrosis (r= - 0.303 and p = 0.007) and morality (r= - 0.432, p = 0.005) while hs-CRP did not show significant correlation.Different levels of serum cortisol in early AP should be considered on initial diagnosis. High cortisol level was a good prognostic indicator for AP with low mortality. This could have further implications on the appropriate initiation of steroid therapy to prevent necrotizing pancreatitis and lower the mortality. Meanwhile, hs-CRP has a low prognostic value in early AP.
- Subjects :
- Male
medicine.medical_specialty
Hydrocortisone
Severity of Illness Index
Gastroenterology
chemistry.chemical_compound
Internal medicine
Lactate dehydrogenase
medicine
Humans
Cortisol level
Kidney
biology
Pancreatitis, Acute Necrotizing
business.industry
C-reactive protein
Healthy subjects
General Medicine
Prognosis
medicine.disease
C-Reactive Protein
medicine.anatomical_structure
chemistry
Case-Control Studies
Acute Disease
biology.protein
Acute pancreatitis
Female
Necrotizing pancreatitis
business
Biomarkers
Serum cortisol
Subjects
Details
- ISSN :
- 00029629
- Volume :
- 363
- Database :
- OpenAIRE
- Journal :
- The American Journal of the Medical Sciences
- Accession number :
- edsair.doi.dedup.....a363f74be4443c8e4fbf93acdf24dc2b
- Full Text :
- https://doi.org/10.1016/j.amjms.2021.09.014