Saudi Journal of Gastroenterology
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ORIGINAL ARTICLE
Year : 2020  |  Volume : 26  |  Issue : 4  |  Page : 216-221

Utility of inflammatory markers to predict adverse outcome in acute pancreatitis: A retrospective study in a single academic center


1 Department of Internal Medicine, School of Medicine, University of Nevada-Las Vegas, Las Vegas, NV, United States
2 School of Medicine, University of Nevada-Las Vegas, Las Vegas, NV, United States
3 Department of Gastroenterology and Hepatology, School of Medicine, University of Nevada-Las Vegas, Las Vegas, NV, United States

Correspondence Address:
Dr. Mohamad Mubder
Department of Internal Medicine, University of Nevada-Las Vegas, School of Medicine, Las Vegas, NV - 89154
United States
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjg.SJG_49_20

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Background/Aim: Acute pancreatitis (AP) is a commonly encountered emergency where early identification of complicated cases is important. Inflammatory markers like lymphocyte to monocyte ratio (LMR) and neutrophil to lymphocyte ratio (NLR) are simple and readily available markers. In this study, we evaluated the utility of these markers in the early identification of patients with complicated AP. Patients and Methods: All patients with a diagnosis of AP admitted to the University Medical Center in Las Vegas/Nevada between August 2015 and September 2018 were identified using ICD-10 codes. Medical records were reviewed retrospectively. Epidemiological measures and their associated confidence intervals were calculated using MedCalc (v. 18). Results: The LMR showed a significant difference between groups, with the non-complicated cases consistently higher than the complicated cases but without significant temporal differences. The NLR showed a significant difference with a significant temporal relation. Using the bound of the 95% confidence interval separating the two groups, LMR <2 was found to be associated with a complicated case and NLR >10.5 was suggestive of a complicated case. High specificity (85–92%) with low sensitivity (23–69%) was noted; hence, these cut points were very good at discerning non-complicated cases. Conclusion: Our data show persistently low LMR that is associated with severe AP and a value of <2.0 can be used clinically to predict severe AP on admission. It also shows that elevated NLR is associated with complicated AP and prolonged hospital stay with a value >10.5 that can be used to predict severe complicated AP and to monitor response to treatment over time.


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