Utility of inflammatory markers to predict adverse outcome in acute pancreatitis: A retrospective study in a single academic center

Mubder, Mohamad; Dhindsa, Banreet; Nguyen, Danny; Saghir, Syed Mohsin; Cross, Chad L.; Makar, Ranjit; Ohning, Gordon V.

doi:10.4103/sjg.sjg_49_20

Cited by 8 publications

(8 citation statements)

References 23 publications

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“…Previous studies focused on the development of rapid systemic inflammatory biomarkers based on accessible laboratory tests for reliable prognosis prediction of AP patients, including RDW, 9 NLR, 9 PLR, 10 and LMR. 11 These systemic inflammatory biomarkers were all reported to be linked with AP severity and poor prognosis. As a novel systemic inflammatory biomarker of GLR, we tried to compare the predictive abilities between NLR, PLR, LMR, and GLR by conducting the ROC curve analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Accumulating researchers have demonstrated that inflammatory biomarkers like NLR, 9 LMR, 10 and PLR 11 playimportant roles in predicting the outcome of AP patients. However, the present study found that these inflammatory biomarkers were not independent prognosis factors to predict in-hospital mortality in critically ill patients with AP when evaluated by Cox regression analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, many researchers have focused on the development of rapid systemic inflammatory biomarkers based on accessible laboratory tests for reliable prognosis prediction of AP patients, 7 , 8 including the red cell distribution width (RDW), 9 neutrophil–lymphocyte ratio (NLR), 9 platelet–lymphocyte ratio (PLR), 10 and lymphocyte–monocyte ratio (LMR). 11 These systemic inflammatory biomarkers were reported to be linked with AP severity and poor prognosis.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of Glucose-to-Lymphocyte Ratio in Critically Ill Patients with Acute Pancreatitis

Chen¹,

Tang²,

Wang³

2021

IJGM

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Background: Glucose metabolism and systemic inflammation have been associated with prognosis in acute pancreatitis (AP) patients. However, the possible value as a prognostic marker of the glucose-to-lymphocyte ratio (GLR) has not been evaluated in critically ill patients with AP. Methods: This study included 1,133 critically ill patients with AP from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database, who were randomly divided into the training cohort (n=806) and the validation cohort (n=327) at a ratio of 7:3. X-tile software was used to determine the optimal cut-off values for GLR. Area under the curve (AUC) analysis was performed to compare the performance between GLR and other bloodbased inflammatory biomarkers. Univariate and multivariate Cox regression analyses were applied to select prognostic factors associated with in-hospital mortality. A nomogram model was developed based on the identified prognostic factors and the validation cohort was used to further validate the nomogram. Results: The optimal cut-off value for GLR was 0.9. The ROC analyses showed that the discrimination abilities of GLR were better than other blood-based inflammatory biomarkers. Multivariate Cox regression analysis demonstrated that age, platelet, albumin, bilirubin, Sequential Organ Failure Assessment (SOFA) score, and GLR are independent predictors of poor overall survival in the training cohort and were incorporated into the nomogram for in-hospital mortality as independent factors. The nomogram exhibited better discrimination with C-indexes in the training cohort and the validation cohort of 0.886 (95% CI=0.849-0.922) and 0.841 (95% CI=0.767-0.915), respectively. The calibration plot revealed an adequate fit of the nomogram for predicting the risk of in-hospital mortality in both sets. Conclusion:As an easily available biomarker, GLR can independently predict the inhospital mortality of critically ill patients with AP. The nomogram combining GLR with other significant features exerted favorable predictive performance for in-hospital mortality.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of Glucose-to-Lymphocyte Ratio in Critically Ill Patients with Acute Pancreatitis

Chen¹,

Tang²,

Wang³

2021

IJGM

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“…Patients with raised NLR not only had an increased risk of mortality but also had increased length of hospital stay in a retrospective audit conducted in Ireland [ 6 ]. Both LMR <2.0 and NLR > 10.5 showed a significant difference with complicated acute pancreatitis [ 21 ]. Certain studies have identified immature granulocytes have more power to discriminate severity of acute pancreatitis than TLC or NLR [ 2 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Hematological Indices Predicting the Severity of Acute Pancreatitis Presenting to the Emergency Department: A Retrospective Analysis

Khan¹,

Kazmi²,

Asghar³

et al. 2021

Cureus

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IntroductionAcute pancreatitis is defined as inflammation of the pancreas. The body responds to inflammation by producing excessive neutrophils and causing programmed cell death of lymphocytes. This leads to immunological instability, which increases the severity of the disease and mortality rate. Recent data suggest that markers of systemic inflammation are able to predict the prognosis of various diseases. Our study aims to assess the severity of acute pancreatitis in conjunction with these hematological markers of systemic inflammation. Materials and methodsOur study was carried out in the emergency medicine department of a tertiary care hospital among patients diagnosed with acute pancreatitis. It was a retrospective study done by reviewing the hospital's medical records. Hematological indices such as hemoglobin levels, packed cell volume (PCV), red blood cell (RBC) count, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), total leukocyte count (TLC), neutrophil count, lymphocyte count, monocyte count, platelet count, neutrophil to lymphocyte count ratio (NLR), lymphocyte to monocyte ratio (LMR), and platelet to lymphocyte ratio (PLR) were observed to be associated with severity of pancreatitis. Those with computed tomography (CT) severity score >=7 were termed as severe pancreatitis, while those below 7 were considered mild to moderate. ResultsA total of 154 patients were included in the final analysis. The mean age of those patients was 48.47 ± 16.71 years. There were 94 male and 60 female patients. There was no difference found among the study groups with respect to mean hemoglobin levels, RBC count, PCV, MCV, MCH, MCHC, lymphocytes, and platelet counts. TLC (p<0.001), neutrophils (p<0.001), monocytes (p=0.008), NLR (p<0.001), and PLR (p=0.006) were found higher in severe pancreatitis, while LMR was found lower in severe pancreatitis (p=0.003). A linear relationship between the hematological indices and CT severity score has shown that TLC (p=0.015), neutrophils (p=0.005), NLR (p=0.001), and PLR (p<0.001) were positively correlated with severity while lymphocyte count (p=0.004) and LMR (p=0.005) were negatively correlated with severe pancreatitis. TLC and LMR were independent predictors of severe pancreatitis with an adjusted odds ratio of 12.80 and 5.47, respectively, on multivariable regression analysis. ConclusionMany markers correlated with the CT severity score, but few of them were able to demonstrate statistical significance on receiver operating characteristic (ROC) analysis.

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“…Red cell distribution width (RDW) has been in use as a prognostic marker for patients admitted to the intensive care units [13] . A continually low lymphocyte to monocyte ratio (LMR) can help us foresee the upcoming SAP on ~ 48 ~ admission 14 . Elevated blood glucose level has also shown some promise in the same 15 .…”

Section: Introductionmentioning

confidence: 99%

Haematological markers as a predicting tool for gallstone induced severe acute pancreatitis

Sharma¹,

Chauhan²,

Gupta³

et al. 2021

Int. J. Surg. Sci.

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Severe acute pancreatitis (SAP) has high morbidity and mortality. Gallstones being the most common cause, warrants study into the haematological markers for swift and easy prediction of gallstone induced SAP. Patients of gallstone induced acute pancreatitis were included in this study. Blood investigations of all patients were sent within one hour of arrival. Computed Tomography (CT) was done after 72 hours of onset of pain. Values of all haematological markers, BISAP and MCTSI were then calculated. 70 patients were included in this study. Area under the ROC curve and cut offs based on these curves for predicting SAP were calculated for NLR, PLR, LMR, RDW, Blood sugar, BISAP (≥3) and MCTSI (>6). Their sensitivity and specificity were then calculated. All tested variables except blood sugar could predict SAP. PLR turned out to the best predictive factor among all. We suggest a combination of NLR and PLR for detecting maximum cases.

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Utility of inflammatory markers to predict adverse outcome in acute pancreatitis: A retrospective study in a single academic center

Cited by 8 publications

References 23 publications

Prognostic Value of Glucose-to-Lymphocyte Ratio in Critically Ill Patients with Acute Pancreatitis

Prognostic Value of Glucose-to-Lymphocyte Ratio in Critically Ill Patients with Acute Pancreatitis

Hematological Indices Predicting the Severity of Acute Pancreatitis Presenting to the Emergency Department: A Retrospective Analysis

Haematological markers as a predicting tool for gallstone induced severe acute pancreatitis

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