A New Marker to Determine Prognosis of Acute Pancreatitis: PLR and NLR Combination Translated title: NOVI MARKER ZA PROGNOZU AKUTNOG PANKREATITISA: KOMBINACIJA PLR I NLR

Summary

Background

We aimed to investigate the prognostic importance of platelet-lymphocyte ratio (PLR) and neutro - phil-lymphocyte ratio(NLR) combination for patients diagnosed with acute pancreatitis and its relationship with mortality.

Methods

This retrospective study was included 142 patients diagnosed with acute pancreatitis. Ranson, Atlanta and BISAP 0h, 24h and 48h scores of the patients were calculated by examining their patient files. The patients were divided into three groups as low-risk, medium-risk and high-risk patients according to their PLR and NLR levels.

Results

The number of patients with acute pancreatitis complications such as necrotizing pancreatitis, acute renal failure, sepsis and cholangitis was significantly higher in the high-risk group compared to other groups. Mortality rate was found to be 90% in the high-risk group, 16% in the medium-risk group, and 1.9% in the low-risk group. The number of patients with a Ranson score of 5 and 6, a severe Atlanta score, a BISAP 0h score of 3 and 4, a BISAP 24h and 48h score of 4 and 5 was higher in the high-risk group compared to other groups. PLR-NLR combination, Atlanta and Ranson scores, and C-reactive protein level were determined to be independent risk factors predicting mortality in stepwise regression model. PLR-NLR combination had the highest area under curve value in terms of predicting acute claspancreatitis prognosis and had a similar diagnostic discrimination with other scoring systems.

Conclusion

In our study it was found that PLR-NLR combination had a similar prognostic importance with other scoring systems used to determine acute pancreatitis prognosis.

Kratak sadržaj

Uvod

Svrha ovog istraživanja je da se utvrdi značajnost kombinacije trombocitno-limfocitnog odnosa (PLR) i neutrofilnolimfocitnog odnosa (NLR) za dijagnostikovanje aktunog pankreatitisa kao i u odnosu na mortalitet.

Metode

Retrospektivno izučavanje obuhvatilo je 142 pacijenta sa dijagnozom akutnog pankreatitisa. Ranson, Atlanta i BISAP 0h, 24h i 48h skorovi kod pacijenata računati su uvidom u istorije bolesti pacijenata. Pacijenti su podeljeni u tri grupe i to niskog, srednjeg i visokog rizika prema nivoima njihovih PLR i NLR.

Rezultati

Broj pacijenata sa akutnim pankreasnim komplikacijama kao što su nekrotizirajuči pankreatitis, akutni renalni poremečaj, sepsa i holangitis bili su znaćajno viši u grupi sa visokim rizikom u odnosu na druge grupe. Nađeno je da je kod visoko rizićne grupe mortalitet iznosio 90%, 16% kod grupe sa srednjim rizikom i 1,9% kod grupe niskog rizika. Broj pacijenata sa Ranson skorom 5 i 6, teškim Atlanta skorom, i BISAP 0h skorom 3 i 4, i BISAP 24h i 48h skorom 4 i 5 je bio viši u grupi sa visokim rizikom u odnosu na druge grupe. Utvrđeno je da su PLR-NLR kombinacija, Atlanta i Ranson skorovi, i nivo C-reaktivnog proteina bili nezavisni faktori rizika u predviđanju mortalitea u regresionom modelu. PLR-NLR kombinacija je imala največu površinu ispod vrednosti krive u predviđanju prognoze akutnog pankreatitisa i slićnu dijagnostićku diskriminaciju sa drugim skor sistemima.

Zaključak

U našem izučavanju nađeno je da PLR-NLR kombinacija ima sličan prognostički značaj sa drugim skor sistemima koji se koriste za utvrđivanje prognoze akutnog pankreatitisa.