PMID- 34513375
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240403
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 13
IP  - 7
DP  - 2021 Jul
TI  - Hematological Indices Predicting the Severity of Acute Pancreatitis Presenting to 
      the Emergency Department: A Retrospective Analysis.
PG  - e16752
LID - 10.7759/cureus.16752 [doi]
LID - e16752
AB  - Introduction Acute pancreatitis is defined as inflammation of the pancreas. The 
      body responds to inflammation by producing excessive neutrophils and causing 
      programmed cell death of lymphocytes. This leads to immunological instability, 
      which increases the severity of the disease and mortality rate. Recent data 
      suggest that markers of systemic inflammation are able to predict the prognosis 
      of various diseases. Our study aims to assess the severity of acute pancreatitis 
      in conjunction with these hematological markers of systemic inflammation. 
      Materials and methods Our study was carried out in the emergency medicine 
      department of a tertiary care hospital among patients diagnosed with acute 
      pancreatitis. It was a retrospective study done by reviewing the hospital's 
      medical records. Hematological indices such as hemoglobin levels, packed cell 
      volume (PCV), red blood cell (RBC) count, mean corpuscular volume (MCV), mean 
      corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), 
      total leukocyte count (TLC), neutrophil count, lymphocyte count, monocyte count, 
      platelet count, neutrophil to lymphocyte count ratio (NLR), lymphocyte to 
      monocyte ratio (LMR), and platelet to lymphocyte ratio (PLR) were observed to be 
      associated with severity of pancreatitis. Those with computed tomography (CT) 
      severity score >=7 were termed as severe pancreatitis, while those below 7 were 
      considered mild to moderate. Results A total of 154 patients were included in the 
      final analysis. The mean age of those patients was 48.47 +/- 16.71 years. There 
      were 94 male and 60 female patients. There was no difference found among the 
      study groups with respect to mean hemoglobin levels, RBC count, PCV, MCV, MCH, 
      MCHC, lymphocytes, and platelet counts. TLC (p<0.001), neutrophils (p<0.001), 
      monocytes (p=0.008), NLR (p<0.001), and PLR (p=0.006) were found higher in severe 
      pancreatitis, while LMR was found lower in severe pancreatitis (p=0.003). A 
      linear relationship between the hematological indices and CT severity score has 
      shown that TLC (p=0.015), neutrophils (p=0.005), NLR (p=0.001), and PLR (p<0.001) 
      were positively correlated with severity while lymphocyte count (p=0.004) and LMR 
      (p=0.005) were negatively correlated with severe pancreatitis. TLC and LMR were 
      independent predictors of severe pancreatitis with an adjusted odds ratio of 
      12.80 and 5.47, respectively, on multivariable regression analysis. Conclusion 
      Many markers correlated with the CT severity score, but few of them were able to 
      demonstrate statistical significance on receiver operating characteristic (ROC) 
      analysis.
CI  - Copyright (c) 2021, Khan et al.
FAU - Khan, Noman A
AU  - Khan NA
AD  - General Surgery, Liaquat National Hospital and Medical College, Karachi, PAK.
FAU - Haider Kazmi, Syed Jawad
AU  - Haider Kazmi SJ
AD  - Emergency Medicine, Liaquat National Hospital and Medical College, Karachi, PAK.
FAU - Asghar, Muhammad Sohaib
AU  - Asghar MS
AD  - Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
FAU - Singh, Manjeet
AU  - Singh M
AD  - Internal Medicine, Liaquat National Hospital and Medical College, Karachi, PAK.
FAU - Iqbal, Shahid
AU  - Iqbal S
AD  - Forensic Medicine, Bacha Khan Medical College, Mardan, PAK.
FAU - Jawed, Rumael
AU  - Jawed R
AD  - Internal Medicine, Liaquat National Hospital and Medical College, Karachi, PAK.
FAU - Muhammad, Lal
AU  - Muhammad L
AD  - Internal Medicine, Liaquat National Hospital and Medical College, Karachi, PAK.
FAU - Kirmani, Tooba Ahmed
AU  - Kirmani TA
AD  - Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
FAU - Ahmed Khan, Salman
AU  - Ahmed Khan S
AD  - Internal Medicine, Dow International Medical College, Karachi, PAK.
FAU - Rajput, Iqra Anees
AU  - Rajput IA
AD  - General Surgery, Civil Hospital Karachi, Karachi, PAK.
LA  - eng
PT  - Journal Article
DEP - 20210730
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC8405398
OTO - NOTNLM
OT  - ct abdomen
OT  - hematological indices
OT  - pancreas
OT  - pancreatitis
OT  - severity scores
COIS- The authors have declared that no competing interests exist.
EDAT- 2021/09/14 06:00
MHDA- 2021/09/14 06:01
PMCR- 2021/07/30
CRDT- 2021/09/13 06:52
PHST- 2021/07/30 00:00 [accepted]
PHST- 2021/09/13 06:52 [entrez]
PHST- 2021/09/14 06:00 [pubmed]
PHST- 2021/09/14 06:01 [medline]
PHST- 2021/07/30 00:00 [pmc-release]
AID - 10.7759/cureus.16752 [doi]
PST - epublish
SO  - Cureus. 2021 Jul 30;13(7):e16752. doi: 10.7759/cureus.16752. eCollection 2021 
      Jul.