Evaluation of Prognostic Factors to Predict the Severity of Acute Pancreatitis

Background: Acute pancreatitis (AP) is a critical inflammatory disorder of the pancreas, commonly characterized by intense abdominal pain accompanied by nausea and vomiting. Laboratory markers that might help predict severity earlier include basic blood tests like white blood cell counts, various cell ratios, and other markers such as CRP.
Aim: To evaluate predictive factors for AP severity in cases admitted to the Emergency Hospital.
Patients and Methods: This prospective observational cohort investigation encompassed adult cases met the revised Atlanta Classification criteria for AP. Data collected included demographic information, clinical history, and laboratory tests (CBC, liver and kidney function, serum biomarkers). Cases received standardized management, including pain control, fluid resuscitation, nutritional support, and antibiotics as necessary. Clinical progression was assessed over a follow-up duration of up to six months.
Results: WBCs, neutrophil levels, and CRP were substantially elevated in severe group at both baseline and follow-up. Additionally, BUN, INR, creatinine, amylase, lipase, serum glucose, and NCI demonstrated substantially higher values in cases with severe disease. Quantitative assessment of pancreatic necrosis revealed a markedly greater incidence of necrotizing AP and necrotic involvement exceeding 30% in severe group. Occurrence of multi-organ failure (MOF) was also substantially higher among these cases. Furthermore, the duration of hospitalization was substantially prolonged in severe group. Both procalcitonin levels and NLR were significantly elevated in this cohort.
Conclusion: These results suggest that monitoring these markers, especially BUN, NCI, and NLR, could be instrumental in early identification and management of severe pancreatitis, potentially guiding more targeted and timely interventions.