The early prognostic value of inflammatory markers in patients with acute pancreatitis

Clin Res Hepatol Gastroenterol. 2019 Jun;43(3):330-337. doi: 10.1016/j.clinre.2018.11.002. Epub 2018 Dec 10.

Abstract

Objectives: The aim of this study was to compare the prognostic value of inflammation-based prognostic markers with the more mature scoring system BISAP in patients with AP and identify the best predictors.

Patients and methods: We retrospectively analysed the data of patients with AP who were treated in our hospital from January 2017 to March 2018 and compared the prognostic value of these inflammation-based prognostic markers with the BISAP score in patients with AP.

Results: Higher BISAP score, NLR, PLR, ACC, and BUN gradually increased (all P < 0.05), and lower LMR and TC (P < 0.001) were associated with severity of AP. Compared with the patients without persistent organ failure, the patients with POF were older (P = 0.049) and had a higher BISAP score (P < 0.001), NLR (P = 0.003), PLR (P < 0.001) and ACC (P = 0.047), BUN (P = 0.011), and creatinine (P = 0.023), RDW (P = 0.021), but lower LMR (P = 0.003) and TC (P < 0.001) at baseline. The BISAP score (OR = 2.117, 95% CI 1.487 to 3.016, P < 0.001), NLR (OR = 1.053, 95% CI: 1.009 to 1.101, P = 0.019) and TC (OR = 0.088, 95% CI: 0.024 to 1.030, P < 0.001) were independent factors for predicting SAP. For predicting the occurrence of POF, TC and PLR had an area under the ROC curve (TC AUC = 0.784, P < 0.001, with a 2.18 cut-off value, PLR AUC = 0.731, P < 0.001, with a 173.13 cut-off value) that was not inferior to the BISAP score (AUC = 0.708), and PLR had the best sensitivity (95.8%), BUN had the best specificity (44.71%), respectively. There is no difference in their predictive value for POF.

Conclusions: NLR and TC are the most powerful markers in this patient series, they have a prognostic value which is not weaker than BISAP, and are equally simple, rapid.

Keywords: Acute pancreatitis; BISAP; Inflammatory markers; Prognostic value.

MeSH terms

  • Biomarkers / metabolism
  • Blood Urea Nitrogen
  • Calcium / blood
  • Cohort Studies
  • Creatinine / blood
  • Female
  • Humans
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Monocytes / metabolism
  • Neutrophils / metabolism
  • Pancreatitis / diagnosis*
  • Platelet Count
  • Prognosis
  • Retrospective Studies
  • Sensitivity and Specificity
  • Serum Albumin / analysis
  • Severity of Illness Index*

Substances

  • Biomarkers
  • Serum Albumin
  • Creatinine
  • Calcium