ISSN :2822-5872
An early prognostic marker for determining disease severity in acute cholangitis: CRP/albumin ratio [ACH Medical Journal]
ACH Medical Journal. 2024; 3(1): 331-337 | DOI: 10.5505/achmedj.2024.78942

An early prognostic marker for determining disease severity in acute cholangitis: CRP/albumin ratio

Sema Nur Arasan1, Osman Inan2, Enes Seyda Sahiner2, Aziz Ahmet Surel3, Emin Altiparmak4, Oguzhan Zengin2, Ihsan Ates2
1Department of Internal Medicine, Oltu State Hospital, Erzurum, Turkey
2Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
3Department of General Surgery, Ankara City Hospital, Ankara, Turkey
4Department of Gastroenterology, Ankara City Hospital, Ankara, Turkey

INTRODUCTION: This study was undertaken to investigate the importance of the CRP/albumin ratio (CAR) as an early prognostic marker for determining disease severity in acute cholangitis.
METHODS: A total of 366 patients aged >18 years diagnosed with acute cholangitis were included in the study. Acute cholangitis severity was determined according to the 2018 Tokyo criteria.
RESULTS: The study population consisted of 49.2% patients with mild, 24.6% moderate, and 26.2% severe acute cholangitis. The cut-off CAR value for predicting moderate risk compared to the mild risk group was found to be >1 with 73.3% sensitivity and 76.7% specificity (AUC±SE: 0.785±0.03; +PV: 61.1%, -PV: 85.2%; p<0.001). The CAR cut-off value for predicting severe risk compared to the moderate risk group was found to be >2.9 with 71.9% sensitivity and 71.1% specificity (AUC±SE: 0.788±0.03; +PV: 72.6%, -PV: 70.3%; p<0.001). The CAR cut-off value for predicting admission to the intensive care unit (ICU) was >2.5 with 77.4% sensitivity and 74.6% specificity (AUC±SE: 0.803±0.03; +PV: 43.1%, -PV: 90.1%; p<0.001). The CAR cut-off value for predicting mortality was >2.8 with 100% sensitivity and 74.9% specificity (AUC±SE: 0.890±0.03; +PV: 19.5%, -PV: 100%; p<0.001). Compared to its components, the CAR was found to exhibit superior diagnostic performance in predicting moderate or severe risk, ICU admission, and mortality.

DISCUSSION AND CONCLUSION: We found that the CAR is a good prognostic marker in determining the severity of acute cholangitis in the early period.

Keywords: Choledocholithiasis, Cholestasis, Cholangitis, Inflammation, Tokyo guidelines

Sema Nur Arasan, Osman Inan, Enes Seyda Sahiner, Aziz Ahmet Surel, Emin Altiparmak, Oguzhan Zengin, Ihsan Ates. An early prognostic marker for determining disease severity in acute cholangitis: CRP/albumin ratio. ACH Medical Journal. 2024; 3(1): 331-337

Corresponding Author: Osman Inan, Türkiye
Manuscript Language: English