The Prognostic Role of Systemic Inflammatory Parameters and Severity Scores in Patients with Acute Pancreatitis

INTRODUCTION: To investigate the predictive power of the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/eosinophil ratio (MER), and C-reactive protein (CRP) level, as well as the harmless acute pancreatitis score (HAPS) and modified computed tomography severity index (mCTSI) score, in patients with acute pancreatitis (AP).
METHODS: This retrospective study comprised adult patients hospitalized for AP. Patients were classified according to disease severity as determined using the HAPS and mCTSI. Systemic inflammatory parameters and demographics were compared among patients to identify factors associated with disease severity.
RESULTS: A total of 442 patients, 199 males (45%) and 243 females (55%), were enrolled in the study. Patients with severe disease had significantly higher mean NLR, PLR, MER, and CRP values compared to those with mild or moderate disease, as per HAPS and mCTSI classifications. Positive correlations were observed between serum NLR, PLR, MER, CRP values, and mCTSI. HAPS was correlated with the NLR, MER, and CRP values. An elevated NLR, MER, and CRP levels were independent predictors of disease severity in patients with AP according to the HAPS and mCTSI.
DISCUSSION AND CONCLUSION: The NLR, MER, and CRP level, but not PLR, in conjunction with the HAPS or mCTSI, might be useful for clinical decision-making in AP severity.