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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

Authors :
Amal Hosni
Hanan Sharaf El-Deen Mohammed
Haidi Karam-Allah Ramadan
Entsar H Ahmed
Abeer A Mokhtar
Reham I El-Mahdy
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.

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