Sahin Abdurrahman
Gastroenterology Department, Faculty of Medicine, Tokat Gaziosmanpasa University, 60030 Tokat, Turkey.
Medicina (Kaunas). 2024 Apr 6;60(4):607. doi: 10.3390/medicina60040607.
: Determining the severity of acute pancreatitis (AP) is the main goal in the early stage of AP. The aim of this study was to compare laboratory parameters and indices, including the neutrophil to lymphocyte ratio (NLR) and the neutrophil-creatinine index (NCI), at admission in order to predict the severity of AP. : Data from 421 patients who were admitted with a diagnosis of AP were collected retrospectively. Disease severity was assessed using the Bedside Index of Severity in Acute Pancreatitis (BISAP) and the revised Atlanta classification (RAC). BISAP was graded as mild and severe, and RAC was graded as mild (MAP), moderately severe (MSAP), and severe (SAP). The laboratory parameters and indices, including the NLR and NCI, were compared. : Of the patients, 70 (16.6%) had severe AP according to BISAP; the AP subgroups according to the RAC were as follows: MAP ( = 213), MSAP ( = 158), and SAP ( = 50). The NCI had the highest area under the receiver operator characteristic (AUROC) curve value (0.862), demonstrating severe disease according to BISAP, with a sensitivity of 78.6% and a specificity of 79.8%. Age (OR:1.046), white blood cell count (WBC) (OR:1.141), hematocrit (OR:1.081), blood urea nitrogen (BUN) (OR:1.040), and NCI (OR:1.076) were independently associated with severe disease, according to the multivariate analysis results, and were determined as components of the newly developed nomogram. The AUROC of the nomogram (0.891) was superior to the AUROCs of all the components of the nomogram except the NCI. Moreover, the NCI was the only parameter to distinguish MSAP from MAP (OR:1.119, 95% CI: 1.015-1.235, = 0.023) and SAP from MSAP (OR:1.095, 95% CI: 1.031-1.162, = 0.003). : The present study enabled the identification of the neutrophil-creatinine index as a new prognostic tool for the assessment of AP severity at hospital admission.
确定急性胰腺炎（AP）的严重程度是AP早期阶段的主要目标。本研究的目的是比较入院时的实验室参数和指标，包括中性粒细胞与淋巴细胞比值（NLR）和中性粒细胞-肌酐指数（NCI），以预测AP的严重程度。
回顾性收集了421例诊断为AP的入院患者的数据。使用急性胰腺炎床边严重程度指数（BISAP）和修订的亚特兰大分类（RAC）评估疾病严重程度。BISAP分为轻度和重度，RAC分为轻度（MAP）、中度重度（MSAP）和重度（SAP）。比较了包括NLR和NCI在内的实验室参数和指标。
根据BISAP，70例（16.6%）患者患有重度AP；根据RAC的AP亚组如下：MAP（=213）、MSAP（=158）和SAP（=50）。NCI在受试者工作特征（AUROC）曲线下面积值最高（0.862），根据BISAP显示为重度疾病，敏感性为78.6%，特异性为79.8%。根据多变量分析结果，年龄（OR：1.046）、白细胞计数（WBC）（OR：1.141）、血细胞比容（OR：1.081）、血尿素氮（BUN）（OR：1.040）和NCI（OR：1.076）与重度疾病独立相关，并被确定为新开发的列线图的组成部分。列线图的AUROC（0.891）优于列线图除NCI外所有组成部分的AUROC。此外，NCI是区分MSAP与MAP（OR：1.119，95%CI：1.015-1.235，=0.023）以及SAP与MSAP（OR：1.095，95%CI：1.031-1.162，=0.003）的唯一参数。
本研究确定中性粒细胞-肌酐指数为一种新的预后工具，用于评估入院时AP的严重程度。
