The Prognostic Role of Systemic Inflammatory Parameters and Severity Scores in Patients with Acute Pancreatitis

Objective: To investigate the predictive power of the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/eosinophil ratio (MER), and C-reactive protein (CRP) levels, as well as the harmless acute pancreatitis score (HAPS) and modified computed tomography severity index (mCTSI) score, in patients with acute pancreatitis (AP).
Material and Methods: This retrospective study included adult patients hospitalized for AP. Patients were classified according to disease severity using HAPS and mCTSI. Systemic inflammatory parameters and demographic data were compared among patients to identify factors associated with disease severity.
Results: A total of 442 patients, 199 males (45%) and 243 females (55%), were enrolled in the study. Patients with severe disease had significantly higher mean NLR, PLR, MER, and CRP values than those with mild or moderate disease according to HAPS and mCTSI classifications. Positive correlations were observed between serum NLR, PLR, MER, CRP, and mCTSI. HAPS was correlated with NLR, MER, and CRP. Elevated NLR, MER, and CRP levels were independent predictors of disease severity in patients with AP according to HAPS and mCTSI.
Conclusion: NLR, MER, and CRP levels, but not PLR, in conjunction with HAPS or mCTSI may be useful for clinical decision-making regarding AP severity.

Keywords: Acute pancreatitis, systemic inflammatory parameters, harmless acute pancreatitis score, modified CT severity index