COMPARATIVE ANALYSIS OF C-REACTIVE PROTEIN /ALBUMIN RATIO AND RANSON CRITERIA FOR EVALUATING THE SEVERITY OF ACUTE PANCREATITIS.

Abstract

Acute pancreatitis is a sudden inflammation of the pancreas, which is characterized by the activation of pancreatic enzymes and auto digestion of the gland itself. It is becoming a prevalent disease in western as well as Asian population including Pakistan. High rates of gallstones and alcohol consumption are the contributing factors to this prevalence The exact prevalence of acute pancreatitis in Pakistan is not well-documented, but estimates indicate that the incidence ranges from 5 to 80 cases per 100,000 people annually, depending on the region and population studied. Acute pancreatitis can clinically be manifested as severe abdominal pain, nausea, vomiting and fever. A few of its common etiologies include gallstones, alcohol, certain medications, and metabolic disorders. It has a wide range in severity from mild, self-limiting episodes to severe, life-threatening complications. The diagnosis of acute pancreatitis is typically confirmed through clinical evaluation, laboratory tests, and imaging studies. Various scoring systems are used to analyze it severity such as Ranson’s criteria, BISAP and APACHE score. In this study a new parameter CRP/Albumin ratio is assessed in comparison of the traditional Ranson’s criteria. After FRC and IRB approval, 105 patients were included age group 18-60 years with a diagnosis of acute pancreatitis. Patients with co-morbidities such as Chronic Liver Disease, Chronic Kidney Disease, or chronic inflammatory were excluded from the study. Age, Gender, Ranson criteria. CRP/Albumin ratio were the parameters of the study. ELISA test was performed for this study. Data was analyzed using SPSS version 25. Quantitative variables such as age, WBC, LDH, AST, serum amylase, serum lipase, CRP, serum albumin, creatinine, serum bilirubin, urea, hematocrit, duration of symptoms, SBP, DBP, heart rate, respiratory rate, SpO2, CRP / Albumin ratio and Ranson score was reported as mean and SD or median (IQR). While qualitative variables such as gender, residence, diabetes, hypertension, smoking and severity of acute pancreatitis was reported as frequency and percentage. Chi- square test and Fisher test were also applied. P value was less than 0.05 and it’s statistically significant. In our study male were greater in number IX than female. More people were from rural areas than urban areas. Most of the patients were smokers, they had diabetes, hypertension and multi organ failure. Our study specified that the CRP/albumin ratio (CAR) has significant advantages over the old Ranson criteria for assessing acute pancreatitis. Unlike the Ranson criteria, which require numerous parameters and a 48-hour assessment time, the CRP/Albumin ratio is a simple, easily accessible blood test that can be evaluated at admission, offering rapid insight into the patient's inflammatory and nutritional status. This enables quicker risk categorization and decision-making. Furthermore, the CAR integrates the dynamic markers of CRP and albumin, indicating both acute inflammation and general health state, whereas the Ranson criteria require a more complex and time-consuming combination of clinical and laboratory measurements. The CRP/Albumin's simplicity and immediacy make it a more practical and potentially more effective tool for early AP control