Role of Inflammatory Markers and Radiological Profile in Predicting Acute Pancreatitis Severity: A Prospective Analysis

Background Acute pancreatitis (AP) is an inflammatory condition of the pancreas that varies in severity. Reliable prognostic markers are essential for early risk stratification. This study evaluates inflammatory markers and severity indices to predict disease outcomes. Aims This prospective observational study aims to assess the prognostic value of various inflammatory markers alongside the Bedside Index for Severity in Acute Pancreatitis (BISAP) and the Computed Tomography Severity Index (CTSI) in patients suffering from AP. Methods This study evaluated the prognostic significance of inflammatory markers in 80 patients with AP. Among these markers are the neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), red cell distribution width (RDW), C-reactive protein (CRP), interleukin-6 (IL-6), and lactate dehydrogenase (LDH). Their correlation with BISAP, CTSI, and Modified CTSI was also analyzed to enhance predictive accuracy. Results Out of 80 patients studied, alcohol was the most common cause, seen in 41 cases (51%). Gallstones were the next major etiology, found in 19 patients (24%). The age of participants ranged from 20 to 80 years, with a mean age of 40.9 ± 13.9 years. A clear male predominance was observed, with 60 (75%) patients being male. In this study, 17 patients (21%) had mild, 54 (68%) moderately severe, and nine (11%) severe pancreatitis. LDH was significantly higher in severe cases (p < 0.0001), with levels above 435 U/L predicting severity with 100% sensitivity and 66.8% specificity. NLR, LMR, and PLR declined significantly during recovery (p = 0.001). Higher LDH, BISAP, CTSI, MCTSI, and urea levels were associated with higher mortality, whereas CRP, IL-6, NLR, amylase, and lipase showed no association with death. Conclusion LDH is a reliable prognostic marker for severe AP, correlating with severity indices and hospital stays. BISAP, CTSI, and MCTSI effectively predicted disease severity. NLR, LMR, and PLR may assist in monitoring recovery.