Comparison of the predictive values of CRP, CRP/albumin, RDW, neutrophil/lymphocyte, and platelet/lymphocyte levels in determining the severity of acute pancreatitis in patients with acute pancreatitis according to the BISAP score

Abstract

BACKGROUND: In our study, it was aimed to fi nd out whether it would be possible to determine the disease severity by comparing the values of red cell distribution width (RDW), c-reactive protein (CRP), CRP/albumin, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) in patients with acute pancreatitis according to Bedside Index of Severity in Acute Pancreatitis (BISAP) scores at the time of admission. METHODS: Five hundred patients diagnosed with acute pancreatitis were included in the study. RESULTS: According to BISAP scores, 388 (77.6 %) patients were evaluated as having mild acute pancreatitis and 112 (22.4 %) patients as having severe acute pancreatitis. In ROC analysis, values of 70.54 % sensitivity and 70.10 % specifi city for CRP, 71.43 % sensitivity and 70.88 % specifi city for CRP/albumin, 80.36 % sensitivity and 30.30 % specifi city for RDW, 75.00 % sensitivity and 43.98 % specifi city for NLR, and 55.36 % sensitivity and 38.51 % specifi city for PLR were determined. Values of 85.71 % sensitivity and 66.49 % specifi city were determined for the NLR-CRP/Albumin-RDW 2** score as a newly created scoring system. CONCLUSION: CRP/albumin, NLR, PLR, and RDW values were found to be statistically signifi cantly higher in patients with severe acute pancreatitis compared to those with mild acute pancreatitis according to the BISAP score (p<0.001). In comparison to previous studies in the literature, similar sensitivity and specifi city values were obtained in determining the severity of the disease with the new NLR-CRP/Albumin-RDW 2** score, and it is thought that this scoring system could be a practical and reliable guide in the treatment and follow-up of patients with acute pancreatitis

Use of the C-Reactive Protein (CRP)/Albumin Ratio as a Severity Tool in Acute Pancreatitis: Systematic Review

“…They also found that the ratio predicted increased hospital and ICU length of stay. Similar conclusions were drawn by Karabuga et al, who analyzed this relationship of severity using the BISAP score [ 11 ]. They found that for a cut-off of 0.0015, the ratio was 71.43% sensitive and 70.88% specific for predicting severe acute pancreatitis.…”

“…All three studies used recognized scoring systems as the standard against which the performance of the CRP/albumin ratio was evaluated; these scoring systems included the Ranson, Atlanta, and BISAP scoring systems. A positive correlation was found between the CRP/albumin ratio at admission and the development of subsequent severe acute pancreatitis in these studies (Tables 2-3) [9][10][11]. The use of the inflammatory ratio involving CRP and prealbumin (PALB) for prognostic purposes can be traced back to 1998 when Pinilla et al established a strong correlation between CRP/PALB with severe organ dysfunction in patients with sepsis [13].…”

“…All three studies used recognized scoring systems as the standard against which the performance of the CRP/albumin ratio was evaluated; these scoring systems included the Ranson, Atlanta, and BISAP scoring systems. A positive correlation was found between the CRP/albumin ratio at admission and the development of subsequent severe acute pancreatitis in these studies (Tables 2 - 3 ) [ 9 - 11 ].…”

The role of erythrocyte distribution width in predicting poor outcomes in geriatric patients with acute pancreatitis

“…6 In order to predict the prognosis, studies on albumin, white blood cell (WBC), and C-reactive protein (CRP) were performed in patients with pancreatitis. [7][8][9] Hematological parameters have been the subject of studies on acute pancreatitis and many other inflammatory diseases. 2,9 Red cell distribution width (RDW), which may increase due to inflammation, ischemia, and hypoxia, is a measure of the mean corpuscular/erythrocyte volume calculated using the standard deviation of erythrocyte volume heterogeneity.…”

“…[7][8][9] Hematological parameters have been the subject of studies on acute pancreatitis and many other inflammatory diseases. 2,9 Red cell distribution width (RDW), which may increase due to inflammation, ischemia, and hypoxia, is a measure of the mean corpuscular/erythrocyte volume calculated using the standard deviation of erythrocyte volume heterogeneity. 10,11 Some studies have previously been conducted to evaluate the association of RDW with a poor prognosis in patients with pancreatitis, mostly comparing patients with pancreatitis with patients without pancreatitis.…”