Analysis of the prognostic value of hematocrit, procalcitonin, albumin combined with Balthazar CT score and APACHE II score in patients with severe acute pancreatitis

This study aims to evaluate the prognostic value of hematocrit (HCT), procalcitonin (PCT), albumin (ALB), and Balthazar CT score combined with APACHE II score in patients with severe acute pancreatitis (SAP). This retrospective cohort study included 102 patients with SAP treated at our hospital from January 2021 to January 2024. All patients were divided into a good prognosis group (68 cases) and a poor prognosis group (34 cases) based on clinical outcomes. Basic information, clinical indicators, laboratory test data, and imaging scores (Balthazar CT score) were collected for all patients, along with APACHE II scores. Multivariate regression analysis was used to identify independent risk factors for poor prognosis, and ROC curve analysis was conducted to evaluate the predictive efficacy of individual indicators and the combined model. There were significant differences between the poor prognosis and good prognosis groups in terms of gender, age, BMI, diabetes, and hypertension (P < .05). Specifically, the mean age in the poor prognosis group was 56.1 ± 12.8 years, significantly higher than that in the good prognosis group (45.3 ± 10.2 years, P = .001). Additionally, the poor prognosis group had significantly higher APACHE II, Ranson, Balthazar CT, and SOFA scores than the good prognosis group (P < .001). Laboratory results showed significantly elevated levels of PCT, white blood cell count, neutrophil percentage, blood glucose, serum creatinine, and total bilirubin in the poor prognosis group, while HCT and ALB levels were significantly lower (P < .001). Multivariate regression analysis identified APACHE II score, Balthazar CT score, and PCT as independent risk factors for poor prognosis, while HCT and ALB levels were protective factors (P < .05). ROC curve analysis revealed that PCT (AUC = 0.85) had the strongest predictive efficacy among individual indicators, while the combined model (APACHE II score, Balthazar CT score, HCT, PCT, and ALB) had the best overall prognostic performance for SAP (AUC = 0.88, P < .001). The combined model of APACHE II score, Balthazar CT score, PCT, HCT, and ALB demonstrates high predictive efficacy for evaluating the prognosis of SAP. This model provides clinicians with more accurate prognostic predictions and exhibits good stability and effectiveness across different patient subgroups.