A Comparative Study Between Neutrophil- Lymphocyte Ratio And Procalcitonin To Predict The Severity Of Acute Pancreatitis Among Patients Attending Tertiary Care Hospital

Abstract

INTRODUCTION:

Acute pancreatitis (AP) is the result of abnormal pancreatic enzyme activation inside acinar cells. ⁽¹⁾ As the severity of acute pancreatitis at the initial stage of manifestation is critical to improve the patients prognosis, there is a need for simple indicator that can easily predict the patient's prognosis within 24 hours of the manifestation of the disease to halt the disease progression and reduce morbidity and mortality. The nature and purpose of this study is to evaluate the ability of serum procalcitonin (PCT) and neutrophil- lymphocyte ration (NLR) as important biochemical markers in predicting the severity of acute pancreatitis for early intervention so as to reduce morbidity and mortality.

OBJECTIVES:

To compare NLR and serum procalcitonin with Modified CT severity index (CTSI) to predict early morbidity and mortality in acute pancreatitis

METHODS:

Neutrophil leukocyte ratio and serum procalcitonin were sent along with other routine investigations on the day of admission in patients diagnosed with acute pancreatitis. Patients are kept nil by mouth and treated conservatively with aggressive IV fluids, IV antibiotics and analgesics. Severity of the disease is graded based on the Modified Atlanta criteria for acute pancreatitis on the day of admission. Patients will undergo a contrast enhanced CT 48 hours after the onset of symptoms and CT severity index is thus obtained.

RESULTS:

The F-value for NLR is 0.47, with a p-value of 0.627, suggesting that NLR ratios do not differ significantly across the severity levels of acute pancreatitis.

The F-value for procalcitonin is 65.28, with a p-value of <0.001, indicating a statistically significant difference in procalcitonin levels across the severity categories.These findings indicate that while procalcitonin is a significant predictor of severity, NLR does not show significant variability with the severity of acute pancreatitis.

CONCLUSION:

This study posits that serum procalcitonin may be more reliable as an early prognostic indicator of severity in cases of acute pancreatitis than NLR. The results demonstrated a noteworthy correlation between procalcitonin and severity levels as categorized by the Modified Atlanta Criteria, suggesting its potential usefulness in clinical decision-making.