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Prognostic value of C-reactive protein-to-albumin ratio in acute pancreatitis: a systematic review and meta-analysis

I Ketut Mariadi1, Gde Somayana1, Christina Permata Shalim2

  • 1Division of Gastroenterology and Hepatology, Faculty of Medicine, Udayana University/Prof Dr. I.G.N.G. Ngoerah Hospital, Denpasar, Bali, Indonesia.

F1000Research
|October 9, 2023
PubMed

Insights

The C-reactive protein-to-albumin (CRP/alb) ratio can predict severe acute pancreatitis (AP) and patient outcomes. A high CRP/alb ratio indicates a poorer prognosis in AP patients.

Area of Science:

  • Gastroenterology
  • Clinical Biochemistry

Background:

  • Acute pancreatitis (AP) presents a significant clinical challenge, with severe cases carrying a high mortality risk.
  • Early and accurate severity assessment is crucial for effective patient management.
  • The prognostic utility of the C-reactive protein-to-albumin (CRP/alb) ratio in AP requires further elucidation.

Approach:

  • A systematic literature review and meta-analysis were conducted, searching PubMed, Science Direct, and Cochrane Library up to January 2023.
  • Studies reporting the admission CRP/alb ratio and its correlation with AP severity or mortality were included.
  • Pooled mean differences and confidence intervals were calculated using a random-effects model, with study quality assessed by the Newcastle-Ottawa scale.

Key Points:

  • The meta-analysis included six studies with 2244 patients.
  • Severe AP exhibited a significantly higher CRP/alb ratio upon admission compared to mild-moderate AP (pooled MD: 3.59; 95% CI: 2.51-4.68; p<0.00001).
  • Non-survivors with AP had a markedly elevated CRP/alb ratio versus survivors (pooled MD: 2.12; 95% CI: 0.43-3.8; p < 0.01).

Conclusions:

  • The CRP/alb ratio serves as a valuable early indicator for predicting poor prognosis in acute pancreatitis.
  • Elevated CRP/alb ratios are associated with increased severity and mortality in AP patients.
  • This ratio offers a potential tool for early risk stratification and timely clinical intervention in AP management.

Keywords:
acute pancreatitisalbuminc-reactive proteinmeta-analysisprognostic

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