Prediction of In-Hospital Mortality in Patients with Acute Pancreatitis: Role of Inflammation-Related Biomarkers.

BACKGROUND

In patients diagnosed with acute pancreatitis (AP), early determination of severity and tailoring treatment for high-risk patients can lead to a reduction in morbidity and mortality. In the emergency department (ED), markers or indices that are quickly accessible, easily calculable, practical, and inexpensive are needed.

OBJECTIVE

We aimed to investigate the performance of inflammatory biomarkers in predicting the in-hospital mortality in patients with AP.

METHODS

Patients admitted to the ED between 2017 and 2024 and diagnosed with AP were retrospectively analyzed. Patients aged ≥18 years who had undergone abdominal computed tomography were included in the study. The diagnosis of AP was evaluated according to the revised Atlanta criteria.

RESULTS

Multivariate logistic regression analysis revealed that the neutrophil-to-lymphocyte ratio (NLR, adjusted odds ratio [OR]: 1.08), systemic immune-inflammation index (SII, adjusted OR: 1), leuko-glycemic index (LGI, adjusted OR: 2.2), and neutrophil-glycemic index (NGI, adjusted OR: 2.411) were independent variables in predicting in-hospital mortality in patients with AP. According to receiver operating characteristic curve analysis, SII demonstrated the best performance in predicting in-hospital mortality (area under the curve (AUC): 0.857), followed by NGI (AUC: 0.850) and NLR (AUC: 0.857). LGI also showed good performance in predicting in-hospital mortality in patients with AP (AUC: 0.829).

CONCLUSION

The present study demonstrates that NLR, SII, LGI, and NGI can be used as independent factors to predict in-hospital mortality in patients with AP. SII and NGI showed the best performance in predicting in-hospital mortality. LGI had the highest sensitivity and the lowest negative likelihood ratio.