Assessing the Predictive Value of Inflammation-based Scores in Acute Pancreatitis Severity

Yıl 2026, Cilt: 7 Sayı: 1, 81 - 90, 31.01.2026

Fırat Canlıkarakaya , Serhat Ocaklı , İbrahim Doğan , Bedri Burak Sucu

https://doi.org/10.47482/acmr.1791954

Öz

Background: Acute pancreatitis (AP) is a disease characterized by acute inflammation of the pancreas and histological destruction of acinar cells, most commonly caused by gallstones or excessive alcohol use. In most patients, the disease is mild, but in approximately 20-30% of cases, it presents in a severe form, which can be life-threatening. The severity of acute pancreatitis is classified as mild, moderate, or severe according to the 2012 revision of the Atlanta classification. Early diagnosis of severe acute pancreatitis (SAP) and identification of patients at high risk for complications are crucial for effective treatment. Several inflammation-based scores, including HALP, CAR, SII, PIV, and SIRI, are used to predict the severity of pancreatitis by evaluating inflammation and nutritional status. The aim of this study is to assess the effectiveness of these inflammation indices in predicting the severity of acute pancreatitis in a group of patients.
Methods: This is a single-center, retrospective study including 213 patients diagnosed with AP. Patients were classified into two groups based on the revised Atlanta criteria: mild acute pancreatitis (MAP) and moderate/severe acute pancreatitis (SAP). The relationship between the severity of AP and various inflammation-based scores (HALP, CAR, SII, PIV, SIRI) were analyzed.
Results: The study included 213 patients. According to the revised Atlanta criteria, 82.6% of patients were diagnosed with mild pancreatitis, 15.5% with moderate pancreatitis, and 1.9% with severe pancreatitis. The HALP score, CAR, PIV, SII and SIRI scores did not show significant differences between the two groups. ROC analysis revealed that these laboratory results and inflammation scores were not significant in predicting the severity of pancreatitis.
Conclusion: This study found no significant association between HALP, CAR, SII, SIRI, or PIV scores and acute pancreatitis severity, contrary to previous research. Larger studies are needed.

Anahtar Kelimeler

Acute pancreatitis , inflammation , revised atlanta criteria

Etik Beyan

The researchers received ethical approval for the study from the Amasya University Non-Interventional Ethics Committee with extension approval number 2024/173. No animal subjects were used in the study. Because the study was retrospective and did not use personal patient information, the ethics committee did not require any consent form.

Destekleyen Kurum

No funding was used in the study.

Teşekkür

No acknowledgement for the study.

AKUT PANKREATİT ŞİDDETİNDE İNFLAMASYON TABANLI SKORLARIN TAHMİNİ DEĞERİNİN DEĞERLENDİRİLMESİ

Öz

Arka Plan: Akut pankreatit (AP), pankreasın akut inflamasyonu ve asiner hücrelerin histolojik yıkımı ile karakterize bir hastalıktır. Akut pankreatitin şiddeti, Atlanta sınıflandırmasının 2012 revizyonuna göre hafif, orta ve şiddetli olarak sınıflandırılır. Şiddetli akut pankreatitin (SAP) erken teşhisi ve komplikasyon riski yüksek hastaların belirlenmesi, etkili tedavi için çok önemlidir. HALP, CAR, SII, PIV ve SIRI dahil olmak üzere çeşitli inflamasyon bazlı skorlar, inflamasyon ve beslenme durumunu değerlendirerek pankreatitin şiddetini tahmin etmek için kullanılır. Bu çalışmanın amacı, bu inflamasyon indekslerinin bir grup hastada akut pankreatitin şiddetini tahmin etmedeki etkinliğini değerlendirmektir.

Yöntemler: Bu, AP tanısı almış 213 hastayı kapsayan tek merkezli, retrospektif bir çalışmadır. Hastalar, revize edilmiş Atlanta kriterlerine göre hafif akut pankreatit (MAP) ve orta/şiddetli akut pankreatit (SAP) olmak üzere iki gruba ayrılmıştır. AP şiddeti ile çeşitli inflamasyon bazlı skorlar (HALP, CAR, SII, PIV, SIRI) arasındaki ilişki analiz edilmiştir.

Bulgular. Çalışmaya 213 hasta dahil edilmiştir. Revize edilmiş Atlanta kriterlerine göre hastaların %82,6'sına hafif pankreatit, %15,5'ine orta şiddette pankreatit ve %1,9'una şiddetli pankreatit tanısı konmuştur. HALP skoru, CAR, PIV, SII ve SIRI skorları iki grup arasında anlamlı bir farklılık göstermemiştir.

Sonuç: Bu çalışmada, önceki araştırmaların aksine, HALP, CAR, SII, SIRI veya PIV skorları ile akut pankreatit şiddeti arasında anlamlı bir ilişki bulunamamıştır. Daha geniş kapsamlı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

akut pankreatit , inflamasyon , revize atlanta kriterleri

Kaynakça

• Garber A, Frakes C, Arora Z, Chahal P. Mechanisms and Management of Acute Pancreatitis. Gastroenterol Res Pract. 2018;6218798.
• van Santvoort HC, Bakker OJ, Bollen TL, Besselink MG, Ahmed Ali U, Schrijver AM, et al. A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology. 2011;141(4):1254-63.
• 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):102-11.
• van Dijk SM, Hallensleben NDL, van Santvoort HC, Fockens P, van Goor H, Bruno MJ, et al. Acute pancreatitis: recent advances through randomised trials. Gut. 2017;66(11):2024-2032.
• Banks PA, Freeman ML; Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101(10):2379-400.
• Farag CM, Antar R, Akosman S, Ng M, Whalen MJ. What is hemoglobin, albumin, lymphocyte, platelet (HALP) score? A comprehensive literature review of HALP's prognostic ability in different cancer types. Oncotarget. 2023;14:153-172.
• Kinoshita A, Onoda H, Imai N, Iwaku A, Oishi M, Tanaka K, et al. The C-reactive protein/albumin ratio, a novel inflammation-based prognostic score, predicts outcomes in patients with hepatocellular carcinoma. Ann Surg Oncol. 2015;22(3):803-10.
• Wang Q, Zhu D. The prognostic value of systemic immune-inflammation index (SII) in patients after radical operation for carcinoma of stomach in gastric cancer. J Gastrointest Oncol. 2019;10(5):965-978.
• Feng JF, Chen S, Yang X. Systemic immune-inflammation index (SII) is a useful prognostic indicator for patients with squamous cell carcinoma of the esophagus. Medicine (Baltimore). 2017;96(4):e5886.
• 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.
• Zeng R, Liu F, Fang C, Yang J, Luo L, Yue P, et al. PIV and PILE Score at Baseline Predict Clinical Outcome of Anti-PD-1/PD-L1 Inhibitor Combined With Chemotherapy in Extensive-Stage Small Cell Lung Cancer Patients. Front Immunol. 2021;12:724443.
• Lin F, Zhang LP, Xie SY, Huang HY, Chen XY, Jiang TC, et al. Pan-Immune-Inflammation Value: A New Prognostic Index in Operative Breast Cancer. Front Oncol. 2022;12:830138.
• Cakcak İE, Kula O. Predictive evaluation of SIRI, SII, PNI, and GPS in cholecystostomy application in patients with acute cholecystitis. Ulus Travma Acil Cerrahi Derg. 2022;28(7):940-946.
• Chu Y, Zhou X, Liu Y, Zhan L, Fang X, Li Y, et al. Systemic Inflammation Response Index (SIRI) Predicts Clinical Outcome and Improves NCCN-IPI Scoring in Primary Gastrointestinal Diffuse Large B-Cell Lymphoma. Blood. 2021;138:1432.
• Kuo DC, Rider AC, Estrada P, Kim D, Pillow MT. Acute Pancreatitis: What's the Score? J Emerg Med. 2015;48(6):762-70.
• Zheng Z, Ding YX, Qu YX, Cao F, Li F. A narrative review of acute pancreatitis and its diagnosis, pathogenetic mechanism, and management. Ann Transl Med. 2021;9(1):69.
• Fujiwara J, Matsumoto S, Sekine M, Mashima H. C-reactive protein predicts the development of walled-off necrosis in patients with severe acute pancreatitis. JGH Open. 2021;5(8):907-914.
• Walker H, Melling J, Jones M, Melling CV. C-reactive protein accurately predicts severity of acute pancreatitis in children. J Pediatr Surg. 2022;57(4):759-764.
• Wu H, Liao B, Ji T, Huang J, Ma K, Luo Y. Diagnostic value of CRP for predicting the severity of acute pancreatitis: a systematic review and meta-analysis. Biomarkers. 2024;29(7):494-503.
• Güler İ, Ustaalioğlu İ. Predictive power of HALP score in estimating short-term mortality in patients with acute pancreatitis. Ulus Travma Acil Cerrahi Derg. 2023;29(10):1098-1102.
• Barlas AM, Altıner S, Başpınar A, Aydın SM, Doğanay E, Kaymak Ş, et al. Predicting complicated acute diverticulitis with the HALP score: A retrospective study. Asian J Surg. 2024;1015-9584(24)02132-8.
• Özkan A, Duman C, Özdemir S. The Role of Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) Score in Acute Pancreatitis - An Analytical Study. Sağlık Bilimlerinde Değer. 2024;14(1):33-8.
• Mariadi IK, Somayana G, Shalim CP, Sindhughosa DA, Daniella D, Purwanta MLA. Prognostic value of C-reactive protein-to-albumin ratio in acute pancreatitis: a systematic review and meta-analysis. F1000Res. 2023;12:748.
• Tarar MY, Khalid A, Choo XY, Khurshid S, Tumeh H, Muhammad K. Use of the C-Reactive Protein (CRP)/Albumin Ratio as a Severity Tool in Acute Pancreatitis: Systematic Review. Cureus. 2022;14(9):e29243.
• Biyik M, Biyik Z, Asil M, Keskin M. Systemic Inflammation Response Index and Systemic Immune Inflammation Index Are Associated with Clinical Outcomes in Patients with Acute Pancreatitis? J Invest Surg. 2022;35(8):1613-1620.
• Balas Ş, Çınkıl NC, Apaydın M. Şiddetli pankreatiti öngörmede yeni biyobelirteç; Sistemik immün-inflamasyon indeksi. Turk J Clin Lab. 2023;14(3):464-9.
• Dao YHT, Huynh TM, Tran DT, Ho PT, Vo TD. Clinical value of the Systemic Inflammatory Response Index for predicting acute pancreatitis severity in Vietnamese setting. JGH Open. 2024;8(6):e13101.