ASSESSING THE PREDICTIVE VALUE OF THE C-REACTIVE PROTEIN AND NEUTROPHIL-TO-LYMPHOCYTE RATIO COMBINED SCORE FOR ORGAN FAILURE IN ACUTE PANCREATITIS

Avaliação do valor preditivo do escore combinado de proteína C-reativa e razão neutrófilo-linfócito para falência de órgãos na pancreatite aguda

ABSTRACT

Background:  Acute pancreatitis (AP) is a common gastrointestinal disorder, with organ failure being the primary cause of mortality. This study evaluates the combined score of C-reactive protein level and neutrophil-to-lymphocyte ratio (C-NLR score), as a predictor of organ failure.

Methods:  A retrospective analysis was conducted on AP patients admitted to the Hospital Clínico Universitario de Valladolid between March 2014 and January 2022. The C-NLR score was calculated from admission data: patients with both elevated neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) were assigned a score of 2, those with one elevated marker received a score of 1, and a score of 0 was given to those with neither.

Results:  A total of 778 patients were included: 611 with mild AP (MAP), 123 with moderately severe AP (MSAP), and 44 with severe AP (SAP). A C-NLR score of 2 was most frequently observed in patients with MSAP (56.1%) and SAP (56.85%), while a score of 1 was more common in patients with MAP (46.9%). Multivariable logistic regression analysis revealed that a C-NLR score of 2 significantly increased the likelihood of organ failure by threefold (OR 3.176; 95% CI 1.297-7.775).

Conclusion:  The C-NLR score could be a useful supplementary tool for predicting organ failure in AP, complementing traditional scoring systems.

Keywords:
Pancreatitis; multiple organ failure; C-reactive protein; organ dysfunction scores