Predictive and Prognostic Value of C-reactive Protein/Albumin and Neutrophil/Lymphocyte Ratio in the Patients Diagnosed with Acute Pancreatitis in Emergency Department

Abstract

Aims: Acute pancreatitis is a severe inflammation of the pancreas presenting sudden onset with high morbidity and mortality. Simple, accessible, cost-efficient and feasible laboratory tests are still needed to demonstrate the prognosis of the patients. The aim of the present study was to search the efficiency of CRP/Alb ratio as a biochemical marker on mortality and clinical progress in the patients diagnosed with acute pancreatitis in correlation with APACHE-2. Methodology: This prospective case-control study was conducted with the patients diagnosed with acute pancreatitis through Atlanta criteria and healthy volunteers as a control group in the emergency department. Demographic characteristics, vital signs, ultrasound reports, clinical outcomes, neutrophil, lymphocyte, neutrophil/lymphocyte ratio (NLR), CRP, albumin and CRP/Alb ratio, APACHE-2 score within control and patient groups were recorded. Logistic regression analysis was performed to distinguish healthy volunteers from acute pancreatitis cases. Results: There was a statistically significant difference between CRP/Albumin and NLR measurements according to the groups and we found that the measurements of the patient group were significantly higher than the control group. The cut-off point for CRP/Albumin and NLR was found to be respectively 1.08, 4.04 and above. (Respectively; sen: 76.64%, 78.50%; spe: 97.20%, 97.20%; PPV: 96.47%, 96.55%; NPV: 80.62%, 81.89%; the accuracy: 86.92%, 87.85%). APACHE-2 scores ranged from 0 to 16, with a mean of 5.80±3.92. The probability of acute pancreatitis was significantly higher in patients with high CRP/Albumin and NLR. Conclusion: This study showed that CRP/Alb ratio and NLR were positively correlated with APACHE-2 scores that designed for prognosis in patients with acute pancreatitis.