The Role of Combined C-reactive Protein and Albumin Indices in Predicting Prolonged Hospital Stay in Acute Pancreatitis: A Prospective Observational Study.

Objective: To evaluate the predictive ability of indices based on the combination of C-reactive protein (CRP) and albumin, namely the CRP/albumin ratio (CAR), Glasgow prognostic score (GPS), and modified GPS (mGPS), for prolonged hospital stay in patients with acute pancreatitis. Methods: This prospective observational study was conducted on patients monitored in the emergency department of a tertiary university hospital. The patients' demographic data, vital signs, laboratory parameters, comorbidities, and length of hospital stay were prospectively recorded. Based on their length of hospital stay, the patients were divided into two groups: prolonged stay (>7 days) and non-prolonged stay. The indices were compared between these groups. Results: There were statistically significant differences in CAR, GPS, and mGPS between the prolonged and non-prolonged hospital stay groups (p<0.001 for all; chi-square test). The area under the curve values of CAR, GPS, and mGPS were calculated as 0.677 [95% confidence interval (CI): 0.601-0.753, p<0.001], 0.637 (95% CI: 0.570-0.704, p<0.001), and 0.671 (95% CI: 0.602-0.740, p<0.001), respectively. According to multivariate analysis, CAR [odds ratio (OR)=1.017, 95% CI (1.003-1.03), p=0.015], GPS [OR=2.894, 95% CI (1.632-5.13), p<0.001], and mGPS [OR=3.757, 95% CI (2.108-6.70), p<0.001] were found to be independent predictors of prolonged hospital stay. Conclusions: CAR, GPS, and mGPS are independent predictors of prolonged hospital stay in patients with acute pancreatitis. The findings also suggest that incorporating CRP levels into prognostic calculations may yield more accurate results compared to scores based solely on albumin levels.