The early prognostic value of inflammatory markers in patients with acute pancreatitis - 18/06/19
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Highlights |
• | The prognostic value of inflammation-based markers and a more mature scoring system is compared in a group of acute pancreatitis cases. |
• | Neutrophil-lymphocyte ratio and total calcium have the same predictive value as bedside index for severity in acute pancreatitis, and are equally simple and rapid. |
Summary |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Acute pancreatitis, Prognostic value, Inflammatory markers, BISAP
Plan
Vol 43 - N° 3
P. 330-337 - juin 2019 Retour au numéro
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