Comparison of the Prognostic Value of Hematologic Inflammatory Markers in Patients with Acute Pancreatitis
Research Article
DOI:
https://doi.org/10.5281/zenodo.13998726Keywords:
Pancreatit, Neutrophil, LymphocyteAbstract
Introduction: Acute pancreatitis (AP) is an inflammatory disease that can also cause a life-threatening clinical picture. AP causes the disease by activating the inflammatory system. Therefore, hematological parameters used as inflammatory markers help to determine the disease progression.
Objective: In this study, we investigated the relationship between hematological parameters and imaging findings with AP severity and survival.
Methods: Data from 312 patients over 18 years of age diagnosed with acute pancreatitis were used for this study. Demographic data, hematologic parameters, and computed tomography of the abdomen were analyzed during hospitalization.
Results: When platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte raito (NLR), amylase/neutrophil and lipase/neutrophil ratios were analyzed according to the severity of AP; while elevated NRL, amylase/neutrophil and lipase/neutrophil ratios were significant in distinguishing between mild and moderate pancreatitis (p < 0.001, p=0.001, p=0.001 and p=0.001, respectively), PLR was not significant (p=0.055). High amylase/neutrophil and lipase/neutrophil ratios were statistically significant in discriminating between moderate and severe pancreatitis (p < 0.001, p=0.01, respectively). When patient survival rates were analyzed after discharge regardless of pancreatitis onset, 90.2% (n=229) of patients were alive, while 9.8% (n=25) died. Statistically, there was no significant difference between pancreatitis severity and death (p=0.837).
Conclusion: The results of our study suggest that systemic immune inflammatory index (SII), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and modified CT severity index (MCTSI) are valuable in the diagnosis of AP. In addition, the ratios of amylase/neutrophilia and lipase/neutrophilia, which we coincidentally found to be significant in our study, have the potential to lead many studies in determining the severity of pancreatitis.
References
Park JH, Byeon HJ, Lee KH, et al. Delta neutrophil index (DNI) as a novel diagnostic and prognostic marker of infection: a systematic review and meta-analysis. Inflammation Research. 2017;66(10):863-870.
Kiat TTJ, Gunasekaran SK, Junnarkar SP, Low JK, Woon W, Shelat VG. Are traditional scoring systems for severity stratification of acute pancreatitis sufficient? Annals of hepato-biliary-pancreatic surgery. 2018;22(2):105-115.
Biyik M, Biyik Z, Asil M, Keskin M. Systemic Inflammation Response Index and Systemic Immune Inflammation Index Are Associated with Clinical Outcomes in Patients with Acute Pancreatitis? Journal of Investigative Surgery. 2022:1-8.
Nathan SD, Mehta J, Stauffer J, et al. Changes in neutrophil–lymphocyte or platelet–lymphocyte ratios and their associations with clinical outcomes in idiopathic pulmonary fibrosis. Journal of Clinical Medicine. 2021;10(7):1427.
Tang B, Li S, Han J, Cao W, Sun X. Associations between blood cell profiles and primary open-angle glaucoma: a retrospective case-control study. Ophthalmic Research. 2020;63(4):413-422.
Chatila AT, Bilal M, Guturu P. Evaluation and management of acute pancreatitis. World journal of clinical cases. 2019;7(9):1006.
Nie L, Cheng Y, Yao F, et al. Comparison of bedside index for severity in acute pancreatitis (BISAP) and modified CT severity index (MCTSI) for predicting the severity of hyperlipidemic acute pancreatitis (HLAP). 2020.
Liu X, Guan G, Cui X, Liu Y, Liu Y, Luo F. Systemic immune-inflammation index (SII) can be an early indicator for predicting the severity of acute pancreatitis: a retrospective study. International Journal of General Medicine. 2021;14:9483.
Portelli M, Jones CD. Severe acute pancreatitis: pathogenesis, diagnosis and surgical management. Hepatobiliary & Pancreatic Diseases International. 2017;16(2):155-159.
Zhang D, Wang T, Dong X, et al. Systemic immune-inflammation index for predicting the prognosis of critically Ill patients with acute pancreatitis. International Journal of General Medicine. 2021;14:4491.
Yao C, Liu X, Tang Z. Prognostic role of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio for hospital mortality in patients with AECOPD. International journal of chronic obstructive pulmonary disease. 2017;12:2285.
Fang T, Wang Y, Yin X, et al. Diagnostic sensitivity of NLR and PLR in early diagnosis of gastric cancer. Journal of Immunology Research. 2020;2020.
Zhang Y, Wu W, Dong L, Yang C, Fan P, Wu H. Neutrophil to lymphocyte ratio predicts persistent organ failure and in-hospital mortality in an Asian Chinese population of acute pancreatitis. Medicine. 2016;95(37).
Kaplan M, Ates I, Oztas E, et al. A new marker to determine prognosis of acute pancreatitis: PLR and NLR combination. Journal of medical biochemistry. 2018;37(1):21.
Alberti P, Pando E, Mata R, et al. Evaluation of the modified computed tomography severity index (MCTSI) and computed tomography severity index (CTSI) in predicting severity and clinical outcomes in acute pancreatitis. Journal of Digestive Diseases. 2021;22(1):41-48.
Gezer NS, Bengi G, Baran A, et al. Comparison of radiological scoring systems, clinical scores, neutrophil-lymphocyte ratio and serum C-reactive protein level for severity and mortality in acute pancreatitis. Revista da Associação Médica Brasileira. 2020;66:762-770.
Harshit Kumar A, Singh Griwan M. A comparison of APACHE II, BISAP, Ranson’s score and modified CTSI in predicting the severity of acute pancreatitis based on the 2012 revised Atlanta Classification. Gastroenterology report. 2018;6(2):127-131.
Mikó A, Vigh É, Mátrai P, et al. Computed tomography severity index vs. other indices in the prediction of severity and mortality in acute pancreatitis: a predictive accuracy meta-analysis. Frontiers in physiology. 2019;10:1002.
Sahu B, Abbey P, Anand R, Kumar A, Tomer S, Malik E. Severity assessment of acute pancreatitis using CT severity index and modified CT severity index: Correlation with clinical outcomes and severity grading as per the Revised Atlanta Classification. Indian J Radiol Imaging. 2017;27(02):152-160. doi:10.4103/ijri.IJRI_300_16
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Europeanatolia Health Sciences Journal
This work is licensed under a Creative Commons Attribution 4.0 International License.