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Amalgamation of systemic inflammatory response syndrome score with C-reactive protein level in evaluating acute
Wei Zheng1, Linqian Zhang1, Gao Long1
1a Department of Gastroenterology , Children's Hospital, Zhejiang University School of Medicine , Hangzhou , Zhejiang , P. R. China.
Insights
Systemic inflammatory response syndrome (SIRS) and C-reactive protein (CRP) levels help assess acute pancreatitis (AP) severity in children. Combining SIRS criteria with CRP offers a valuable tool for evaluating pediatric AP cases.
Area of Science:
- Pediatric critical care medicine
- Gastroenterology
- Inflammatory response syndromes
Background:
- Systemic inflammatory response syndrome (SIRS) is a critical physiological response to injury.
- Acute pancreatitis (AP) in children can be complicated by SIRS, necessitating accurate severity assessment.
- Understanding SIRS's role in pediatric AP is crucial for timely intervention.
Purpose of the Study:
- To analyze clinical features of pediatric AP with SIRS complications.
- To investigate the utility of SIRS score combined with C-reactive protein (CRP) levels in assessing AP severity in children.
Main Methods:
- Retrospective cohort study of 111 children hospitalized with AP.
- Analysis of demographic data, clinical information, and laboratory results on admission.
- Statistical examination of SIRS presence and its correlation with clinical parameters and outcomes.
Main Results:
- 45 out of 111 pediatric AP cases presented with SIRS.
- SIRS was associated with significantly higher levels of CRP, IL-6, and other inflammatory markers.
- Coexisting diseases and fever were independent risk factors for SIRS in pediatric AP.
- SIRS independently predicted AP severity (OR=10.820, p=0.005).
- An optimal CRP cut-off of 27.5 mg/L was identified for severe AP classification (AUC=0.733).
Conclusions:
- The combination of SIRS criteria and CRP levels shows promise for assessing pediatric AP severity.
- This combined approach may improve the accuracy of classifying severe AP in children.
- Further research can validate this combined scoring system for clinical application.
Background And Aim:
Systemic inflammatory response syndrome (SIRS) has to do with how the body reacts to injury. Herein, we analyzed the clinical features of acute pancreatitis (AP) in children with SIRS complication and investigated the role of SIRS score combined with C-reactive protein (CRP) level in assessing AP severity in children.
Methods:
This retrospective cohort study involved 111 children hospitalized with AP at the Children's Hospital of Zhejiang University School of Medicine between January 2012 and August 2017. Presence of SIRS, demographic data, clinical information and laboratory test results on admission were statistically examined.
Results:
Out of the 111 AP cases, 45 were diagnosed with SIRS. Differences in CRP, interleukin-6 (IL-6), age, temperature, heart rate (HR), white blood cell (WBC), neutrophil count (NC), body mass index (BMI), duration of onset of disease symptoms as well as cases requiring intensive care unit (ICU) treatment were significantly higher in patients with SIRS than those without SIRS (p < .01 or p < .05). Logistic regression analyses evinced two independent risk factors for SIRS to be coexisted diseases (odds ratio (OR) = 4.871, p = .02) and fever (OR = 3.56, p = .007). SIRS was an independent predictor for AP severity (OR = 10.820, p = .005). The optimal cut-off value of CRP was 27.5 mg/L for severe AP classification according to receiver operating characteristic (ROC) (area under curve was 0.733).
Conclusion:
Amalgamation of SIRS criterion with CRP level potentially plays an important role in assessing AP severity in children.
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