Cholesterol, Urea Nitrogen, CRP, And IL-4 as Independent Predictors for Severe Acute Pancreatitis: A Retrospective Study

Aim: To investigate the expression and correlation between laboratory indicators, such as urea nitrogen, cholesterol, and inflammatory markers in patients with severe acute pancreatitis (AP) within 24 hour of admission and provide new insights for the early identification of severe acute pancreatitis (SAP). Materials and Methods:A retrospective study was conducted on patients with AP admitted between January 2022 and December 2022.According to the revised atlanta classification, patients were categorized into the mild acute pancreatitis (MAP) group (N=112) and the moderately severe acute pancreatitis/severe acute pancreatitis (MSAP)/SAP group (N=45).Clinical data were compared between two groups.Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for severe AP.The predictive value of the model was assessed using the area under the ROC area under the curve (AUC).Results: Compared with the MAP group, The MSAP/SAP group exhibited significantly higher proportions of fatty liver, diabetes, and hypertriglyceridemia, along with elevated levels of cholesterol, fibrinogen, urea nitrogen, bilirubin, neutrophil-to-lymphocyte ratio, C-reactive protein, D-dimer, interleukin-4, interleukin-6, and interleukin-10 (p<0.05).The multivariate logistic regression analysis revealed that cholesterol [odds ratio (OR): 1.278, 95% confidence interval (CI): 1.085-1.562,p=0.007], urea nitrogen (OR: 1.478, 95% CI: 1.203-1.976,p=0.002),C-reactive protein (OR: 1.016, 95% CI: 1.006-1.027,p=0.002), and interleukin-4 (OR: 2.151, 95% CI: 1.470-3.564,p<0.001) were the independent risk factors for early severe AP.The AUC of the combined prediction model incorporating these four factors was 0.932 (95% CI: 0.884-0.979),demonstrating a sensitivity of 97% and a specificity of 75%.It exhibited superior diagnostic efficacy compared to any single indicators and the commonly used BISAP scoring system. Conclusion:This study identified cholesterol, urea nitrogen, C-reactive protein, and interleukin-4 as significant independent risk factors for the early development of severe AP.A novel predictive model was developed incorporating these four biomarkers, which demonstrated superior diagnostic efficacy compared with any single indicator and the conventional BISAP score.This model assists clinicians with a simple, objective, and powerful tool for early risk stratification of AP patients within 24 hour of admission.