Comparison of the Prognostic Value of Hematologic Inflammatory Markers in Patients with Acute Pancreatitis

ABSTRACT Introduction: Acute pancreatitis (AP) is an inflammatory disease that can also cause a life-threatening clinical picture. AP causes the disease by activating the inflammatory system. Therefore, hematological parameters used as inflammatory markers help to determine the disease progression. Objective: In this study, we investigated the relationship between hematological parameters and imaging findings with AP severity and survival. Methods: Data from 312 patients over 18 years of age diagnosed with acute pancreatitis were used for this study. Demographic data, hematologic parameters, and computed tomography of the abdomen were analyzed during hospitalization. Results: When platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte raito (NLR), amylase/neutrophil and lipase/neutrophil ratios were analyzed according to the severity of AP; while elevated NRL, amylase/neutrophil and lipase/neutrophil ratios were significant in distinguishing between mild and moderate pancreatitis (p < 0.001, p=0.001, p=0.001 and p=0.001, respectively), PLR was not significant (p=0.055). High amylase/neutrophil and lipase/neutrophil ratios were statistically significant in discriminating between moderate and severe pancreatitis (p < 0.001, p=0.01, respectively). When patient survival rates were analyzed after discharge regardless of pancreatitis onset, 90.2% (n=229) of patients were alive, while 9.8% (n=25) died. Statistically, there was no significant difference between pancreatitis severity and death (p=0.837). Conclusion: The results of our study suggest that systemic immune inflammatory index (SII), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and modified CT severity index (MCTSI) are valuable in the diagnosis of AP. In addition, the ratios of amylase/neutrophilia and lipase/neutrophilia, which we coincidentally found to be significant in our study, have the potential to lead many studies in determining the severity of pancreatitis. Keywords: Pancreatit, Neutrophil, Lymphocyte.