C - reactive protein to albumin ratio as predictor of severity and outcome in acute pancreatitis.

Early and accurate prediction of severity in acute pancreatitis remains a major clinical challenge, particularly in resource-limited settings. Hence, this cross-sectional study evaluated 100 patients to assess the prognostic value of the CRP/Albumin ratio (CAR) in comparison with BISAP and other parameters. Disease severity was mild in 40%, moderate in 30% and severe in 30%, with ICU admission in 23% and overall mortality of 5%, increasing with severity. Non-survivors had significantly higher age (62.6 ± 7.09 vs 40.41 ± 13.66 years), urea (78.72 ± 66.08 vs 24.09 ± 13.99 mg/dL), creatinine (2.69 ± 1.68 vs 0.84 ± 0.43 mg/dL), CRP (182.61 ± 141.55 vs 75.98 ± 82.76 mg/L), CAR (107.18 ± 106.30 vs 28.09 ± 38.10) and BISAP scores (4.6 ± 0.55 vs 0.85 ± 0.99), along with lower albumin levels (2.11 ± 0.87 vs 3.20 ± 0.98 g/dL). Thus, BISAP showed the highest predictive accuracy (AUC = 1.000), followed by creatinine (0.985), age (0.952) and CAR (0.930).