A retrospective study of the role of biochemical parameters such as NlR,PLR, CRP/albumin ratio in predicting the severity of the disease in patientsdiagnosed with acute pancreatitis

Objective: The aim of this study was to determine the role of markers that can be obtained from routine blood tests such as Neutrophil/Lymphocyte Ratio, Platelet/Lymphocyte Ratio, CRP/Albumin, LDH/Albumin and RDW in predicting the severity of acute pancreatitis with Ranson and BISAP scores. Method: The data of patients admitted to Pamukkale University Emergency Department and diagnosed with acute pancreatitis were analysed retrospectively from 31.08.2022 on Probel Hospital Information Management System and 210 patients were included in the study with a power of %95. NLR, PLR, CRP/Albumin, LDH/Albumin and RDW values were determined for each patient and the correlation with the severity of the disease was evaluated by calculating the Ranson and BISAP scores. Results: Among the patients diagnosed with acute pancreatitis, 56.2% were female and 43.8% were male. Patients diagnosed with biliary origin as the cause of pancreatitis were the majority with 84.8%. The mean age of the patients between 18 and 96 years was 62.40 years. The mean NLR value was 13.03, PLR value was 263.09, RDW value was 14.21, CRP/ALB value was 0.20, and LDH/ALB value was 9.96. The mean Ranson score was 1.07 and the mean BISAP score was 1.04. According to the Ranson score, 21 patients were considered severe and 16 patients were considered severe according to the BISAP score. While 16 of the patients included in the study received intensive care hospitalisation, there were 8 patients with mortality. A statistically significant correlation was found between Ranson score and NLR, PLR and LDH/ALB (p=0.001, p=0.001, p=0.002, respectively). A statistically significant relationship was found between BISAP score and NLR, CRP/ALB and LDH/ALB (p<0.001, p<0.001, p=0.01, respectively). A statistically significant correlation was found between history of intensive care unit hospitalisation and NLR and CRP/ALB (p=0.001, p<0.01, respectively). A statistically significant relationship was found between mortality and CRP/ALB (p<0.001). While there was a correlation between BISAP score and intensive care hospitalisation and mortality (p<0.001), Ranson score was not correlated with intensive care hospitalisation and mortality (p>0.05). According to the results of the ROC analysis of the data found to be significant according to the Ranson score, NLR cut-off ≥11.87 ≥ AUC:0.74, sensitivity 71.4% and specificity 68.8%, PLR cut-off ≥240.28 ≥ AUC: 0.65, sensitivity 66.7% and specificity 62.4%, ≥ AUC:0.82, sensitivity 81% and specificity 77.2% at LDH/ALB cut-off ≥11.13. According to the results of ROC analysis of the data found to be significant according to the BISAP score, NLR cut-off ≥12.02 with AUC:0.74, sensitivity 75% and specificity 69.1%, CRP/ALB cut-off ≥0.34 with AUC: 0.71, sensitivity 68.8% and specificity 65.5%, ≥ AUC:0.67, sensitivity 68.1% and specificity 63.9% at LDH/ALB cut-off ≥9.68. Conclusion: According to our study, NLR and LDH/ALB were found significant with both severity scores. CRP/ALB was found to be significant with BISAP, intensive care hospitalisation and mortality. Therefore, the combined use of NLR, LDH/ALB and CRP/ALB data obtained from routine blood tests to be performed at the time of admission of patients diagnosed with acute pancreatitis is highly important in predicting the severity and prognosis of the disease. Keywords: Acute Pancreatitis, Ranson, BISAP, NLR, CRP/ALB, LDH/ALB