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Inflammatory indices as an indicator of acute pancreatitis severity

Yıl 2025, Cilt: 16 Sayı: 54, 38 - 44, 12.04.2025
https://doi.org/10.17944/interdiscip.1503687

Öz

Objective: The present study aimed to compare C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), neutrophil/albumin ratio (NAR), platelet/leukocyte ratio (PLR), systemic immune inflammation (SII), systemic inflammation response index (SIRI) and Ranson criteria associated with inflammation in acute pancreatitis (AP). Thus, the study aimed to analyze the significance ranking of these parameters in terms of disease severity.
Method: The present retrospective study was conducted after the ethics committee approval was obtained. The study included 221 AP patients visited hospital between 01.01.2018 and 31.12.2023. The patients were categorized into two groups based on Ranson criteria: Group 1 (Ranson≤2, n=147) and Group 2 (Ranson≥3, n=74). Basic participant demographics, laboratory reports, CRP, NLR, NAR, PLR, SII,
SIRI and hospitalization periods were recorded in a data form, and the findings were analyzed.
Results: There was no difference between the groups based on gender (p=0.094). The Group 2 patients were older (p<0.001) than the ones in Group 1. Furthermore, CRP (p=0.001), NLR (p<0.001), NAR (p<0.001), PLR (p<0.001), SII (p<0.001) and SIRI (p<0.001) were higher in Group 2 patients when compared to Group 1. Also, the hospitalization period was significantly longer in Group 2 (p<0.001) compared to Group 1.
Conclusion: In the study, it was determined that the CRP, NAR, PLR, NLR, SII and SIRI findings were significantly higher in AP patients with a Ranson criteria ≥ 3, and a positive correlation was found between Ranson criteria and inflammatory parameters.

Kaynakça

  • Ruiz-Rebollo ML, Muñoz-Moreno MF, Mayo-Iscar A, Udaondo-Cascante MA, Nistal RB. Statin intake can decrease acute pancreatitis severit. Pancreatology. 2019;19(6):807-812. doi: 10.1016/j.pan.2019.07.004.
  • James TW, Crockett SD. Management of acute pancreatitis in the first 72 hours. Curr Opin Gastroenterol. 2018;34(5):330-335. doi: 10.1097/MOG.0000000000000456.
  • Li Y, Zhao Y, Feng L, Guo R. Comparison of the prognostic values of inflammation markers in patients with acute pancreatitis: a retrospective cohort study. BMJ Open. 2017;7(3):e013206. doi: 10.1136/bmjopen-2016-013206.
  • Asghar MS, Khan NA, Haider Kazmi SJ, Ahmed A, Hassan M, Jawed R, et al. Hematological parameters predicting severity and mortality in COVID-19 patients of Pakistan: a retrospective comparative analysis. J Community Hosp Intern Med Perspect. 2020;10(6):514-520. doi: 10.1080/20009666.2020.1816276.
  • Liu Y, Du X, Chen J, Jin Y, Peng L, Wang HHX, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020;81(1):e6-e12. doi: 10.1016/j.jinf.2020.04.002.
  • Tingle SJ, Severs GR, Goodfellow M, Moir JA, White SA. NARCA: A novel prognostic scoring system using neutrophil-albumin ratio and Ca19-9 to predict overall survival in palliative pancreatic cancer. J Surg Oncol. 2018;118(4):680-686. doi: 10.1002/jso.25209.
  • Wang B, Li D, Cheng B, Ying B, Gong Y. The Neutrophil Percentage-to-Albumin Ratio Is Associated with All-Cause Mortality in Critically ill Patients with Acute Kidney Injury. Biomed Res Int. 2020;2020:5687672. doi: 10.1155/2020/5687672.
  • Gong Y, Li D, Cheng B, Ying B, Wang B. Increased neutrophil percentage-to-albumin ratio is associated with all-cause mortality in patients with severe sepsis or septic shock. Epidemiol Infect. 2020;148:e87. doi: 10.1017/S0950268820000771.
  • Xie R, Xiao M, Li L, Ma N, Liu M, Huang X, et al. Association between SII and hepatic steatosis and liver fibrosis: A population-based study. Front Immunol. 2022;13:925690. doi: 10.3389/fimmu.2022.925690.
  • Geng Y, Zhu D, Wu C, Wu J, Wang Q, Li R, et al. A novel systemic inflammation response index (SIRI) for predicting postoperative survival of patients with esophageal squamous cell carcinoma. Int Immunopharmacol. 2018;65:503-510. doi: 10.1016/j.intimp.2018.10.002.
  • Balas Ş, Çınkıl CN, Apaydın M. Şiddetli pankreatiti öngörmede yeni biyobelirteç; Sistemik immün-inflamasyon indeksi. Turk J Clin Lab. 2023; 3: 464-469. doi: 10.18663/tjcl.1333413
  • Altuğ E, Çakir A, Kilavuz H, Şener K, Eyüpoğlu G, Güven R. Diagnostic Value of Systemic Immuneinflammation Index in Patients with Acute Pancreatitis. Southern Clinics of Istanbul Eurasia. 2023;34(2). doi: 10.14744/scie.2023.70893.
  • Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-111. doi: 10.1136/gutjnl-2012-302779.
  • Zeytunlu M, Akyıldız M, Tekeşin O, Ersöz G, Özütemiz Ö, Çoker A, et al. Akut pankreatit olgularının kanıta dayalı tıp kılavuzları rehberliğinde incelenmesi. Akademik Gastroenteroloji Dergisi 2005;4:146-53.
  • Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174(2):331-336. doi: 10.1148/radiology.174.2.2296641.
  • Jense EH, Borja D, Al-Refaıe WB, Vickers SM. Exocrine Pancreas. In: Sabiston DC, editor. Sabiston Textbook of Surgery. 19th ed. Philadelphia: W.B. Saunders; 2012; p:1515-1547.
  • Brunicardi FC, Anderson DK, Biliar TR, Dunn DL, Hunter JG, Pollock RE. Pankreas. In: Fisher EW, Andersen DK, Bell RH, Saluja AK, Brunicardi FC, editors. Schwartz’s Princıples of Surgery. Schwartz Cerrahinin İlkeleri. 8. Baskı, Çeviren: Geçim İE, Demirkan A, Tarlan Yayıncılık, Ankara. 2008;s:1265-1340.
  • Rau BM, Kemppainen EA, Gumbs AA, Büchler MW, Wegscheider K, Bassi C, et al. Early assessment of pancreatic infections and overall prognosis in severe acute pancreatitis by procalcitonin (PCT): a prospective international multicenter study. Ann Surg. 2007;245(5):745-754. doi: 10.1097/01.sla.0000252443.22360.46.
  • Pepys MB, Hirschfield GM. C-reactive protein: a critical update [published correction appears in J Clin Invest. 2003;112(2):299]. J Clin Invest. 2003;111(12):1805-1812.
  • Mantovani A, Cassatella MA, Costantini C, Jaillon S. Neutrophils in the activation and regulation of innate and adaptive immunity. Nat Rev Immunol. 2011;11(8):519-531. doi: 10.1038/nri3024.
  • Cho SK, Jung S, Lee KJ, Kim JW. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can predict the severity of gallstone pancreatitis. BMC Gastroenterol. 2018;18(1):18. doi: 10.1186/s12876-018-0748-4.
  • Stokes KY, Granger DN. Platelets: a critical link between inflammation and microvascular dysfunction. J Physiol. 2012;590(5):1023-1034. doi: 10.1113/jphysiol.2011.225417.
  • Suppiah A, Malde D, Arab T, Hamed M, Allgar V, Smith AM, et al. The prognostic value of the neutrophil-lymphocyte ratio (NLR) in acute pancreatitis: identification of an optimal NLR. J Gastrointest Surg. 2013;17(4):675-681. doi: 10.1007/s11605-012-2121-1.
  • Sun T, Shen H, Guo Q, Yang J, Zhai G, Zhang J, et al. Association between Neutrophil Percentage-to-Albumin Ratio and All-Cause Mortality in Critically Ill Patients with Coronary Artery Disease. Biomed Res Int. 2020;2020:8137576. doi: 10.1155/2020/8137576
  • Ferro M, Babă DF, de Cobelli O, Musi G, Lucarelli G, Terracciano D, et al. Neutrophil percentage-to-albumin ratio predicts mortality in bladder cancer patients treated with neoadjuvant chemotherapy followed by radical cystectomy. Future Sci OA. 2021;7(7):FSO709. doi: 10.2144/fsoa-2021-0008.
  • Tawfik B, Mokdad AA, Patel PM, Li HC, Huerta S. The neutrophil to albumin ratio as a predictor of pathological complete response in rectal cancer patients following neoadjuvant chemoradiation. Anticancer Drugs. 2016;27(9):879-883. doi: 10.1097/CAD.0000000000000411.
  • Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20(23):6212-6222. doi: 10.1158/1078-0432.CCR-14-0442.
  • Dionisie V, Filip GA, Manea MC, Movileanu RC, Moisa E, Manea M, et al. Neutrophil-to-Lymphocyte Ratio, a Novel Inflammatory Marker, as a Predictor of Bipolar Type in Depressed Patients: A Quest for Biological Markers. J Clin Med. 2021;10(9):1924. doi: 10.3390/jcm10091924.
  • Bartl T, Bekos C, Postl M, Alexander R, Polterauer S, Stefanie A, et al. The systemic immune-inflammation index (SII) is an independent prognostic parameter of survival in patients with invasive vulvar cancer. J Gynecol Oncol. 2021;32(1):e1. doi: 10.3802/jgo.2021.32.e1.
  • Erdogan T. Role of systemic immune-inflammation index in asthma and NSAID-exacerbated respiratory disease. Clin Respir J. 2021;15(4):400-405. doi: 10.1111/crj.13314.
  • Altuğ E, Altundağ İ, Çakır A, Şener K, Korkut S, Güven R. Prognostic Value of Systemic Immune-inflammation Index in Patients with Pediatric Blunt Abdominal Trauma. Glob Emerg Crit Care. 2024 Aug;3(2):87-92. doi:10.4274/globecc.galenos.2024.30074.
  • Liu X, Guan G, Cui X, Liu Y, Liu Y, Luo F. Systemic Immune-Inflammation Index (SII) Can Be an Early Indicator for Predicting the Severity of Acute Pancreatitis: A Retrospective Study. Int J Gen Med. 2021;14:9483-9489. Published 2021 Dec 8. doi:10.2147/IJGM.S343110.
  • Yasak İ.H ve Yılmaz M. The relationship between systemic immune inflammation index and length of hospitalization in acute pancreatitis. AAnn Clin Anal Med 2023;14(4):340-344.
  • Silva-Vaz P, Jarak I, Rato L, Oliveira PF, Morgado-Nunes S, Paulino A, et al. Plasmatic Oxidative and Metabonomic Profile of Patients with Different Degrees of Biliary Acute Pancreatitis Severity. Antioxidants (Basel). 2021;10(6):988. doi: 10.3390/antiox10060988.
Yıl 2025, Cilt: 16 Sayı: 54, 38 - 44, 12.04.2025
https://doi.org/10.17944/interdiscip.1503687

Öz

Kaynakça

  • Ruiz-Rebollo ML, Muñoz-Moreno MF, Mayo-Iscar A, Udaondo-Cascante MA, Nistal RB. Statin intake can decrease acute pancreatitis severit. Pancreatology. 2019;19(6):807-812. doi: 10.1016/j.pan.2019.07.004.
  • James TW, Crockett SD. Management of acute pancreatitis in the first 72 hours. Curr Opin Gastroenterol. 2018;34(5):330-335. doi: 10.1097/MOG.0000000000000456.
  • Li Y, Zhao Y, Feng L, Guo R. Comparison of the prognostic values of inflammation markers in patients with acute pancreatitis: a retrospective cohort study. BMJ Open. 2017;7(3):e013206. doi: 10.1136/bmjopen-2016-013206.
  • Asghar MS, Khan NA, Haider Kazmi SJ, Ahmed A, Hassan M, Jawed R, et al. Hematological parameters predicting severity and mortality in COVID-19 patients of Pakistan: a retrospective comparative analysis. J Community Hosp Intern Med Perspect. 2020;10(6):514-520. doi: 10.1080/20009666.2020.1816276.
  • Liu Y, Du X, Chen J, Jin Y, Peng L, Wang HHX, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020;81(1):e6-e12. doi: 10.1016/j.jinf.2020.04.002.
  • Tingle SJ, Severs GR, Goodfellow M, Moir JA, White SA. NARCA: A novel prognostic scoring system using neutrophil-albumin ratio and Ca19-9 to predict overall survival in palliative pancreatic cancer. J Surg Oncol. 2018;118(4):680-686. doi: 10.1002/jso.25209.
  • Wang B, Li D, Cheng B, Ying B, Gong Y. The Neutrophil Percentage-to-Albumin Ratio Is Associated with All-Cause Mortality in Critically ill Patients with Acute Kidney Injury. Biomed Res Int. 2020;2020:5687672. doi: 10.1155/2020/5687672.
  • Gong Y, Li D, Cheng B, Ying B, Wang B. Increased neutrophil percentage-to-albumin ratio is associated with all-cause mortality in patients with severe sepsis or septic shock. Epidemiol Infect. 2020;148:e87. doi: 10.1017/S0950268820000771.
  • Xie R, Xiao M, Li L, Ma N, Liu M, Huang X, et al. Association between SII and hepatic steatosis and liver fibrosis: A population-based study. Front Immunol. 2022;13:925690. doi: 10.3389/fimmu.2022.925690.
  • Geng Y, Zhu D, Wu C, Wu J, Wang Q, Li R, et al. A novel systemic inflammation response index (SIRI) for predicting postoperative survival of patients with esophageal squamous cell carcinoma. Int Immunopharmacol. 2018;65:503-510. doi: 10.1016/j.intimp.2018.10.002.
  • Balas Ş, Çınkıl CN, Apaydın M. Şiddetli pankreatiti öngörmede yeni biyobelirteç; Sistemik immün-inflamasyon indeksi. Turk J Clin Lab. 2023; 3: 464-469. doi: 10.18663/tjcl.1333413
  • Altuğ E, Çakir A, Kilavuz H, Şener K, Eyüpoğlu G, Güven R. Diagnostic Value of Systemic Immuneinflammation Index in Patients with Acute Pancreatitis. Southern Clinics of Istanbul Eurasia. 2023;34(2). doi: 10.14744/scie.2023.70893.
  • Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-111. doi: 10.1136/gutjnl-2012-302779.
  • Zeytunlu M, Akyıldız M, Tekeşin O, Ersöz G, Özütemiz Ö, Çoker A, et al. Akut pankreatit olgularının kanıta dayalı tıp kılavuzları rehberliğinde incelenmesi. Akademik Gastroenteroloji Dergisi 2005;4:146-53.
  • Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174(2):331-336. doi: 10.1148/radiology.174.2.2296641.
  • Jense EH, Borja D, Al-Refaıe WB, Vickers SM. Exocrine Pancreas. In: Sabiston DC, editor. Sabiston Textbook of Surgery. 19th ed. Philadelphia: W.B. Saunders; 2012; p:1515-1547.
  • Brunicardi FC, Anderson DK, Biliar TR, Dunn DL, Hunter JG, Pollock RE. Pankreas. In: Fisher EW, Andersen DK, Bell RH, Saluja AK, Brunicardi FC, editors. Schwartz’s Princıples of Surgery. Schwartz Cerrahinin İlkeleri. 8. Baskı, Çeviren: Geçim İE, Demirkan A, Tarlan Yayıncılık, Ankara. 2008;s:1265-1340.
  • Rau BM, Kemppainen EA, Gumbs AA, Büchler MW, Wegscheider K, Bassi C, et al. Early assessment of pancreatic infections and overall prognosis in severe acute pancreatitis by procalcitonin (PCT): a prospective international multicenter study. Ann Surg. 2007;245(5):745-754. doi: 10.1097/01.sla.0000252443.22360.46.
  • Pepys MB, Hirschfield GM. C-reactive protein: a critical update [published correction appears in J Clin Invest. 2003;112(2):299]. J Clin Invest. 2003;111(12):1805-1812.
  • Mantovani A, Cassatella MA, Costantini C, Jaillon S. Neutrophils in the activation and regulation of innate and adaptive immunity. Nat Rev Immunol. 2011;11(8):519-531. doi: 10.1038/nri3024.
  • Cho SK, Jung S, Lee KJ, Kim JW. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can predict the severity of gallstone pancreatitis. BMC Gastroenterol. 2018;18(1):18. doi: 10.1186/s12876-018-0748-4.
  • Stokes KY, Granger DN. Platelets: a critical link between inflammation and microvascular dysfunction. J Physiol. 2012;590(5):1023-1034. doi: 10.1113/jphysiol.2011.225417.
  • Suppiah A, Malde D, Arab T, Hamed M, Allgar V, Smith AM, et al. The prognostic value of the neutrophil-lymphocyte ratio (NLR) in acute pancreatitis: identification of an optimal NLR. J Gastrointest Surg. 2013;17(4):675-681. doi: 10.1007/s11605-012-2121-1.
  • Sun T, Shen H, Guo Q, Yang J, Zhai G, Zhang J, et al. Association between Neutrophil Percentage-to-Albumin Ratio and All-Cause Mortality in Critically Ill Patients with Coronary Artery Disease. Biomed Res Int. 2020;2020:8137576. doi: 10.1155/2020/8137576
  • Ferro M, Babă DF, de Cobelli O, Musi G, Lucarelli G, Terracciano D, et al. Neutrophil percentage-to-albumin ratio predicts mortality in bladder cancer patients treated with neoadjuvant chemotherapy followed by radical cystectomy. Future Sci OA. 2021;7(7):FSO709. doi: 10.2144/fsoa-2021-0008.
  • Tawfik B, Mokdad AA, Patel PM, Li HC, Huerta S. The neutrophil to albumin ratio as a predictor of pathological complete response in rectal cancer patients following neoadjuvant chemoradiation. Anticancer Drugs. 2016;27(9):879-883. doi: 10.1097/CAD.0000000000000411.
  • Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20(23):6212-6222. doi: 10.1158/1078-0432.CCR-14-0442.
  • Dionisie V, Filip GA, Manea MC, Movileanu RC, Moisa E, Manea M, et al. Neutrophil-to-Lymphocyte Ratio, a Novel Inflammatory Marker, as a Predictor of Bipolar Type in Depressed Patients: A Quest for Biological Markers. J Clin Med. 2021;10(9):1924. doi: 10.3390/jcm10091924.
  • Bartl T, Bekos C, Postl M, Alexander R, Polterauer S, Stefanie A, et al. The systemic immune-inflammation index (SII) is an independent prognostic parameter of survival in patients with invasive vulvar cancer. J Gynecol Oncol. 2021;32(1):e1. doi: 10.3802/jgo.2021.32.e1.
  • Erdogan T. Role of systemic immune-inflammation index in asthma and NSAID-exacerbated respiratory disease. Clin Respir J. 2021;15(4):400-405. doi: 10.1111/crj.13314.
  • Altuğ E, Altundağ İ, Çakır A, Şener K, Korkut S, Güven R. Prognostic Value of Systemic Immune-inflammation Index in Patients with Pediatric Blunt Abdominal Trauma. Glob Emerg Crit Care. 2024 Aug;3(2):87-92. doi:10.4274/globecc.galenos.2024.30074.
  • Liu X, Guan G, Cui X, Liu Y, Liu Y, Luo F. Systemic Immune-Inflammation Index (SII) Can Be an Early Indicator for Predicting the Severity of Acute Pancreatitis: A Retrospective Study. Int J Gen Med. 2021;14:9483-9489. Published 2021 Dec 8. doi:10.2147/IJGM.S343110.
  • Yasak İ.H ve Yılmaz M. The relationship between systemic immune inflammation index and length of hospitalization in acute pancreatitis. AAnn Clin Anal Med 2023;14(4):340-344.
  • Silva-Vaz P, Jarak I, Rato L, Oliveira PF, Morgado-Nunes S, Paulino A, et al. Plasmatic Oxidative and Metabonomic Profile of Patients with Different Degrees of Biliary Acute Pancreatitis Severity. Antioxidants (Basel). 2021;10(6):988. doi: 10.3390/antiox10060988.
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Research Articles
Yazarlar

Muhammed Fuad Uslu 0000-0001-6300-5130

Esra Timurkaan 0000-0001-5654-7070

Mustafa Timurkaan 0000-0003-1950-0489

Mustafa Yılmaz 0000-0002-4457-428X

Yayımlanma Tarihi 12 Nisan 2025
Gönderilme Tarihi 23 Haziran 2024
Kabul Tarihi 16 Mart 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 16 Sayı: 54

Kaynak Göster

Vancouver Uslu MF, Timurkaan E, Timurkaan M, Yılmaz M. Inflammatory indices as an indicator of acute pancreatitis severity. Interdiscip Med J. 2025;16(54):38-44.