Comparison of bisap score and predictive values of CRP, CRP/albumin,RDW, neutrophil/lymphocyte, platelet/lymphocyte levels in determiningacute pancreatitis severity in acute pancreatitis patients

ABSTRACT Comparison of BISAP Score and Predictive Values of CRP, CRP/Albumin, RDW, Neutrophil/Lymphocyte, Platelet/Lymphocyte Levels in Determining Acute Pancreatitis Severity in Acute Pancreatitis Patients Objective: In our study, we aimed to determine predictive values in determining acute pancreatitis severity by comparing the BISAP score at the time of admission with CRP, CRP/Albumin, neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR) and RDW values in 500 acute pancreatitis patients hospitalized in Department of Internal Medicine and Department of Gastroenterology in Ankara City Hospital. Material and Methods: Our study was designed retrospectively and 500 acute pancreatitis patients hospitalized in in Department of Internal Medicine and Department of Gastroenterology in Ankara City Hospital between February 2019 and march 2020 were included in the study. Patients under 18 years of age, pregnant patients and patients with active malignancies were excluded from the study. It was planned to compare the BISAP score at the time of admission with the CRP, CRP/albümin, PLR, NLR and RDW values. The measured parameters of patients were recorded retrospectively from the hospital information system. Statistical analyzes were performed with using SPSS version 17.0 program and In statistical analysis, p<0.05 value was accepted as significant. Findings: A total of 500 patients diagnosed with acute pancreatitis, 247 (49.4%) male and 253 (50.6%) female, were included in our study. The mean age of the patients was 55.68 ± 18.30 years. 215 (43%) patients were 60 years and older. According to the BISAP scoring, 388 (77.6%) patients were evaluated as mild acute pancreatitis, 112 (22.4%) patients were evaluated as severe acute pancreatitis. There were 139 patients with non-biliary acute pancreatitis and 361 patients with biliary acute pancreatitis. The number of patients diagnosed with diabetes mellitus (DM) is 103 (20.6%), the number of patients diagnosed with hypertension (HT) is 183 (36.6%), the number of patients with a diagnosis of coronary artery disease (CAD) is 74 (14.8%), the number of patients diagnosed as other disease in the group was 151 (30.2%). The number of patients died was 23. (4.6%) Age, WBC, neutrophil (NEU), NLR, PLR, RDW, CRP and CRP/Alb values were statistically significantly higher in those in the severe acute pancreatitis group than those in the mild acute pancreatitis group, while platelet (PLT), lymphocyte (LY) and albumin (Alb) values were statistically significantly lower. (p <0.001) In ROC analysis, 70.54% sensitivity and 70.10% specificity for CRP, 71.43% sensitivity and 70.88% specificity for CRP / Alb value, 80.36% sensitivity and 30.30% specificity for RDW, 75.00% sensitivity and 43.98% specificity for NLR, 55.36% sensitivity and 38.51% specificity values were obtained for PLR (PLT / LY) value. Age, lymphocyte (LY) (p <0.001), neutrophil (NEU) (p = 0.006), NLR (p <0.001), PLR (p <0.001) values were statistically significanty higher in the biliary acute pancreatitis group compared to the non-biliary acute pancreatitis group. The albumin (Alb) value was found to be statistically significantly lower. (p <0.001) Being 60 years old and above and female patients rates (p <0.001), hypertension rate (p = 0.024), mortality rate (p = 0.010), BUN> 25 (p = 0.008) and the pleural effusion rate (p <0.001) were statistically significantly higher, while the rate of other diseases among comorbidities was statistically significantly lower (p = 0.017) in the biliary acute pancreatitis group compared to the non-biliary acute pancreatitis group. Conclusion: As a result of our study, CRP, CRP / albumin, PLR, NLR and RDW values were found to be statistically significantly higher in patients with severe acute pancreatitis than patients with mild acute pancreatitis according to the BISAP scoring. (p<0,001) It was concluded that all of these parameters measured in the ROC analysis had a high predictive value in determining the severity of the disease, and these parameters, which can be easily accessed and can be calculated in a simple way, can be used in determining the severity of the disease in patients with acute pancreatitis. Key Words: Acute Pancreatitis, CRP, CRP / Albumin Ratio, RDW, Platelet-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio, BISAP Score