The Prognostic Value of Inflammatory Markers to Predict Adverse Clinical Course of Acute Pancreatitis

Background/Aim: Prognosis of complications is important in patients with acute pancreatitis (AP). The aim was to determine the severity of AP based on changes of inflammatory markers (IM). Material and Methods: WBC, immature granulocytes (IG), neutrophil-lymphocytes ratio (NLR) and the C-reactive protein (CRP) were compared in 243 patients with moderately severe pancreatitis (MSP) and in 59 patients with acute severe pancreatitis (ASP). Results: WBC count was significantly more in ASP compare to MSP group (15.4±2.3×109/l. vs. 12.7±1.2×109/l.). IG percentage was high in ASP group; however, lymphocytes count was lower in ASP. NLR during early 48 hours decreased in MSP; but significantly increased in ASP group. The “cut off” for NLR was determined as 10.5. 3-weeks survival in patients with NLI<10.5 was 95.9%. In patients with NLI>10.5 the survival was 79.2% and mortality raised up to 21.8%. IG in MSP group was 0.39±0.21% and 1.7±0.51% in ASP.CRP on admission was not differ between groups, but increased in ASP in 2nd day and was significantly higher compare to MSP. Conclusion: NLR can predict the survival on admission, but CRP only 2nd day achieve the predictive value. Rational evaluating of IM during early 2 days can predict the further clinical course of AP.