THE ROLE OF C-REACTIVE PROTEIN IN THE EVALUATION OF THE SEVERITY OF ACUTE CHOLECYSTITIS

¹Ankara Ataturk Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey - ²Ankara Ataturk Training and Research Hospital, Department of General Surgery, Ankara, Turkey - ³Ankara Kecioren Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey

¹Ankara Ataturk Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey - ²Ankara Ataturk Training and Research Hospital, Department of General Surgery, Ankara, Turkey - ³Ankara Kecioren Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey

Introduction: Acute cholecystitis (AC) is the acute inflammation of the gallbladder wall. Tokyo guidelines provide criteria for the diagnosis and classification of AC. We aimed this study to identify the role of C-reactive protein (CRP) in determining the severity of AC and determine cut-off levels for each group.

Materials and methods: A retrospective analysis was made of 236 patients diagnosed with AC between January 2009 and January 2015. The patients were divided into three groups according to the Tokyo classification. CRP values of the patients were analyzed and compared among the groups.

Results: Disease severity was determined as mild in 57.6%, moderate in 28.8% and severe in 13.6% of the patients. The mean age was 53.7±18.3 years and the clinical picture was seen to become more severe with increasing age (p<0.05). CRP values of the patients were determined to rise with increasing grade (p<0.05). There was no relationship between CRP and white blood cell (WBC) (p>0.05). The CRP cut-off values were determined as 0.815 mg/dl (sensitivity 44.9%, specificity 34%) for the Grade 1 patient group, 1.095 mg/dl (sensitivity 57.4%, specificity 57.7%) for the Grade 2 patient group and 2.095 mg/dl (sensitivity 71.9%, specifi- city 69.6%) for the Grade 3 patient group.

Conclusion: CRP values may be useful in assessing the severity of AC, and may be considered to be a parameter that could be added to the Tokyo classification.