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

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 tower 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. (C) 2018 Elsevier Masson SAS. All rights reserved.