Journal of Gastroenterology and Digestive Diseases

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The Comparison of Apache Ii Scores with Neutrophil Lymphocyte Ratio and Red Cell Distribution Width for the Prediction of Prognosis of Patients with Acute Pancreatitis

Objective Acute pancreatitis is an inflammatory process of pancreatic tissue. Its severity can range from mild inflammation to severe, progressive pancreatic necrosis, and it can lead to multiorgan failure that may have a mortality rate as high as 20% to 30%. Materials and Methods The aim of this study was to compare the efficacy of acute physiology and chronic health evacuation II (APACHE II) scoring system with neutrophil lymphocyte ratio (NLR) and Red blood cell distribution width (RDW) level in predicting prognosis of patients with acute pancreatitis. Healthy subjects were included as the control group. According to the Atlanta classification system, patients having an APACHE II score of less than 8 were classified as the mild pancreatitis group, and those with an APACHE II score of equal to or greater than 8 were classified as the severe pancreatitis group. Both groups were compared with each other with respect to admission NLR and RDW. Results The study included a total of 494 patients with a mean age of 59.15 ± 19.46 years, of whom 363 were women and 131 were men. The control group included a total of 47 subjects with a mean age of 57.34 ± 7.17, of whom 18 were men and 29 were women. When we compared the control and patient groups with respect to NLR and RDW values, we found significant differences between both groups. The severe pancreatitis group had a significantly higher mean NLR compared to the mild pancreatitis group. The dead patients had higher NLR and RDW values compared to the surviving ones, although only the NLR difference between the dead and surviving patients reached statistical significance. Conclusion Both NLR and RDW are elevated in acute pancreatitis, although only NLR should be considered as a readily available, inexpensive, and useful marker for predicting disease severity and mortality. Keywords: Neutrophil lymphocyte ratio; APACHE score; Ranson criteria; Imrie scores

Author(s): Murat Orak, Mehmet Ust√ľnda, Mehmet Nezir Gullu, Ayhan Ozhasenekler, Hasan Mansur Durgun, Cahfer Guloglu