Clinical Value of Neutrophil CD64 Index, PCT, and CRP in Acute Pancreatitis Complicated with Abdominal Infection

Wang, Biao; Tang, Rongzhu; Wu, Shaohong; Liu, Ming; Kanwal, Fariha; Rehman, Muhammad Fayyaz ur; Wu, Fang; Zhu, Jun

doi:10.3390/diagnostics12102409

Cited by 7 publications

(6 citation statements)

References 42 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We observed significantly higher CRP, neutrophils, and DNI levels in the SAP group. These findings align with the existing literature, as pancreatitis is characterized by an intense inflammatory response (19). However, it is worth noting that the median DNI value in our SAP group in our study appears to be lower than the study conducted by Kim et al in 2019, which is the only study that examines the role of DNI in pancreatitis (14).…”

Section: Discussionsupporting

confidence: 90%

The role of delta neutrophil index in early identification of severe acute pancreatitis in adult patients: a prospective diagnostic accuracy study

İslam,

Osoydan Satıcı,

Ademoğlu

et al. 2023

Med Sci Discov

View full text Add to dashboard Cite

Objective: The primary outcome of this study is to evaluate the diagnostic performance of the initial delta neutrophil index (DNI) for early identification of severe acute pancreatitis (SAP). Material and Methods: All diagnoses and definitions were made according to the revised Atlanta classification. DNI (delta neutrophil index) was measured automatically using a hematology analyzer. The study included patients aged 18 years and older who were admitted with abdominal pain consistent with acute pancreatitis. The exclusion criteria encompassed patients with a known diagnosis of pancreatic malignancy, iatrogenic endoscopic pancreatitis, those presenting with abdominal trauma, and those experiencing exacerbation of chronic pancreatitis. Results: The median DNI for patients who developed SAP was 0.5 (0.29-1.1), while for non-severe patients, it was 0.2 (0.1-0.41). The difference between the two outcome groups was found to be statistically significant (p<0.001). The area under the curve (AUC) for DNI in predicting SAP was 0.727, with a 95% Confidence Interval (CI) of 0.628-0.825. At the optimal cut-off point, the sensitivity of DNI was determined to be 74.3%, with a 95% CI of 56.7%-87.5%. The specificity was calculated as 68.2% (95% CI=61.6%-74.3%). The positive likelihood ratio (LR+) was 2.34, with a 95% CI of 1.78-3.08, and the negative likelihood ratio (LR-) was 0.38, with a 95% CI of 0.21-0.67. Conclusion: Based on the results, the delta neutrophil index (DNI) shows promise as an essential inflammatory marker for the early diagnosis of SAP. While it may not demonstrate high performance as a standalone marker, our study indicates that DNI could serve as an independent predictor for this outcome. The significant difference observed in DNI values between patients who developed SAP and non-severe patients suggests its potential clinical significance in identifying severe acute pancreatitis cases at an early stage. Further investigations and validation studies are warranted to strengthen the reliability and generalizability of DNI as a diagnostic tool for SAP. Integrating DNI with other relevant clinical and laboratory parameters may enhance its diagnostic accuracy and contribute to more effective patient management strategies. With appropriate intervention and follow-up, the early identification of SAP using DNI may lead to improved patient outcomes and reduced complications, benefiting both the patients and the healthcare system.

show abstract

Section: Discussionsupporting

confidence: 90%

The role of delta neutrophil index in early identification of severe acute pancreatitis in adult patients: a prospective diagnostic accuracy study

İslam,

Osoydan Satıcı,

Ademoğlu

et al. 2023

Med Sci Discov

View full text Add to dashboard Cite

show abstract

“…It has been suggested that PCT is a valuable marker in infection-related inflammatory response [20]. It has also been suggested to be a predictor of IPN, associated with morphology of necrosis and the severity of systematic complications [21]. Results of this study showed that the PCT values on the 1st, 4th, and 7th days after admission of both IPN and non-IPN group patients were above normal, with IPN patients having even higher PCT values, suggesting it as a good candidate parameter for IPN prediction.…”

Section: Discussionmentioning

confidence: 99%

Early Predictors of Infected Pancreatic Necrosis in Severe Acute Pancreatitis: Implications of Neutrophil to Lymphocyte Ratio, Blood Procalcitonin Concentration, and Modified CT Severity Index

Zhu¹,

Li²,

Zhu³

et al. 2023

Dig Dis

View full text Add to dashboard Cite

Background: Infected pancreatic necrosis (IPN) accounts for 30% mortality in severe acute pancreatitis (SAP). Early prediction of IPN occurrence is critical for prophylactic measures to be taken. This study aimed to evaluate the predicting value for IPN of combined markers at early stages of SAP. Methods: The clincial records of 324 SAP patients admitted within 48 hours after disease onset were retrospectively analyzed. As potential predictors, the neutrophil to lymphocyte ratio (NLR), blood procalcitonin concentration (PCT) on the 1st, 4th and 7th day post admission, as well as modified computerized tomography severity index (MCTSI) on the 5 – 7th day post admission, were extracted. Correlations between these features with IPN were analyzed using logistic regression, and predictive values were estimated using the Receiver operating characteristic (ROC) curve analyses. Results: NLR, PCT, body mass index (BMI) and MCTSI were significantly higher in IPN group (p < 0.001) compared to the control, among which NLR, PCT and MCTSI were identified as independent predictors for IPN in logistic regression model. Combination of these parameters yielded signficant predicting valuse with an area under curve (AUC) of 0.92, sensitivity of 97.2% and specificity of 77.2% in ROC curve analysis. Conclusion: Combination of NLR, PCT, MCTSI might facilitate the prediction of IPN occurrence in SAP patients.

show abstract

“…PCT is a potential biomarker to estimate infection,which is actually valuable to guidance of antibiotic use and therapy estimation [31] .The concentration of PCT will increase in patients with AP,which is an important index to predict HTG-AP severity.The elevated procalcitonin (PCT) level was also used as a reference for the presence or absence of secondary local or systemic infection [32] .We often use CRP to estimate the degree of tissue damage and inflammation [33] ,but all predictors in this model excluded it.Considering CRP as an inflammatory response protein, it has not been fully mobilized in the early stage of the disease (within 24h) and is gradually increasing. It is also pointed out in the guidelines that serum CRP is an important indicator reflecting SIRS or infection, and serum CRP ≥ 150 mg /L indicates the severity of AP, but the evaluation time is 72 hours after the onset .…”

Section: Discussionmentioning

confidence: 99%

Analysis of risk factors for progression of hypertriglyceridemic acute pancreatitis and establishment of ultra-early prediction model

Yang,

Guo,

Jiang

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: To analyze the risk factors of disease progression in patients with hypertriglyceridemic acute pancreatitis (HTG-AP), and to establish a prediction model for ultra-early (24h) severity of the disease. Methods: A total of 205 eligible patients diagnosed with HTG-AP who were hospitalized in Zhuhai people's Hospital (Zhuhai hospital affiliated with Jinan University) were included. Among them,147 patients were enrolled in the modular group and 58 patients were enrolled in the validation group.Based on R language analysis (version 3.6.3), the R package glmnet package was used to conduct Lasso regression analysis on variables (P<0.05) with inter-group differences and select the optimal predictive variables which can predict disease progression in early. The R package (rms package) was used and the optimal prediction variables were analyzed by Logistic regression. Then, the Decision Curve Analysis (DCA) was drawn to further verify the benefits of clinical patients in the model. Finally, external verification was carried out to further assess the predictive efficiency and generalizability of the risk prediction model. Results: (1).There were no statistical difference in the basic data (including sex,age,basic disease) between mild group and severe group in the modular group(P>0.05). (2).There were statistical difference in the laboratory results (including GLU,Cr,PCT,TG,CHOL and D-dimer) between mild group and severe group in the modular group(P<0.05). (3).The results of multivariate Lasso regression indicated that GLU,Cr,PCT,TG,CHOL and D-dimer were independent predictors of hypertriglyceridemic acute pancreatitis severity. The optimal prediction variables were analyzed by Logistic regression. (4).Nomogram was drawn by rms package. The AUC was 0.788 and the C-index was 0.788. The C-index of internal verification was C-index=0.788(95%CI：0.785-0.791). Decision Curve Analysis showed that the prediction model had better clinical usefulness than active treatment or negative treatment if the threshold probability is within 12%-99%. (5).In the validation group, the AUC and C-index of external verification were 0.821(95%CI:0.714-0.928). Decision Curve Analysis showed that the prediction model had better clinical usefulness than active treatment or negative treatment if the threshold probability is within 10%-99%. Conclusions: TG, CHOL, D-dimer and PCT within 24 hours of HTG-AP onset were the risk factors which could aggravate disease progression. The early prediction model based on the four risk factors could relatively accurately predict exacerbation trend in early phase of hypertriglyceridemic acute pancreatitis.

show abstract

Clinical Value of Neutrophil CD64 Index, PCT, and CRP in Acute Pancreatitis Complicated with Abdominal Infection

Cited by 7 publications

References 42 publications

The role of delta neutrophil index in early identification of severe acute pancreatitis in adult patients: a prospective diagnostic accuracy study

The role of delta neutrophil index in early identification of severe acute pancreatitis in adult patients: a prospective diagnostic accuracy study

Early Predictors of Infected Pancreatic Necrosis in Severe Acute Pancreatitis: Implications of Neutrophil to Lymphocyte Ratio, Blood Procalcitonin Concentration, and Modified CT Severity Index

Analysis of risk factors for progression of hypertriglyceridemic acute pancreatitis and establishment of ultra-early prediction model

Contact Info

Product

Resources

About