Assessing the Predictive Value of Inflammation-based Scores in Acute Pancreatitis Severity
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
Destekleyen Kurum
No funding was used in the study.
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.
Teşekkür
No acknowledgement for the study.
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.