SII in combination with hsCRP predict the risk of pancreatitis after endoscopic retrograde cholangiopancreatography

Abstract

Objective To investigate the relationship between the development of post-ERCP pancreatitis(PEP)and the systemic immune-inflammatory index (SII) and high-sensitivity C-reactive protein (hsCRP) levels in patients treated via endoscopic retrograde cholangiopancreatography(ERCP), and to further analyze the predictive value of SII in combination with hsCRP for PEP. Methods The clinical data of patients treated with ERCP in our department from January 2021 to December 2022 were retrospectively analyzed.Restricted cubic splines were used to determine the correlation between SII and hsCRP and the risk of PEP.Logistic regression was used to analyze the factors affecting PEP.Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of SII, hsCRP and their combined levels for PEP. Results Restricted cubic spline analysis showed that SII > 669.06×109/L and hsCRP > 13.94mg/dL were positively correlated with the incidence of PEP.The incidence of PEP increases with the development of inflammatory state.The area under the receiver operating characteristic curve of SII combined with hsCRP was 0.819, which was higher than that of SII or hsCRP alone.Multiple logistic regression analysis showed that the risk factors for PEP were female proportion,the maximum diameter of large choledochal stones, blood amylase measured three hours after surgery, and elevation of SII and hsCRP. Conclusion Within a specific range, elevated inflammatory markers SII and hsCRP are risk factors for developing PEP after ERCP.The combination of SII and hsCRP was more accurate in predicting the risk of PEP than either biomarker alone.