Acute Pancreatitis, Pancreatitis
Conditions
Keywords
Neutrophil-to-lymphocyte ratio, NLR, Systemic immune-inflammation index, Platelet-to-lymphocyte ratio, Prognostic markers, SII
Brief summary
This prospective observational study aims to evaluate the prognostic value of complete blood count (CBC)-derived inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), for predicting severe acute pancreatitis and 28-day mortality in adult patients admitted with acute pancreatitis.
Detailed description
Acute pancreatitis (AP) ranges from mild self-limiting disease to severe forms associated with persistent organ failure, infected necrosis, and substantial mortality. Early identification of patients at high risk of severe disease is essential for appropriate triage and management. CBC-derived inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) are inexpensive and widely available markers that have demonstrated prognostic value in critical illness. Their specific role in predicting severity and mortality in acute pancreatitis requires further evaluation. This prospective observational study will assess admission and early serial CBC-derived indices as predictors of severe acute pancreatitis (defined by the revised Atlanta criteria) and 28-day all-cause mortality, and will compare their predictive performance with standard clinical severity scores including APACHE II and BISAP.
Interventions
None listed
Sponsors
Assiut University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years * Diagnosis of acute pancreatitis based on at least two of the following: characteristic abdominal pain, serum amylase or lipase ≥ 3× upper limit of normal, or imaging consistent with acute pancreatitis * Admission within 72 hours of symptom onset
Exclusion criteria
* Chronic pancreatitis without an acute episode * Severe immunosuppression (neutropenia \< 500/mm³ or high-dose immunosuppressive therapy after solid organ transplantation) * Active non-pancreatic infection on admission requiring systemic antibiotics * Refusal to provide informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Severe acute pancreatitis | Up to 28 days | Occurrence of severe acute pancreatitis defined as persistent organ failure lasting more than 48 hours according to the revised Atlanta criteria (using Marshall or SOFA score thresholds) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 28-day all-cause mortality | 28 days | All-cause mortality within 28 days from hospital admission. |
| Initiation of systemic antibiotics | During index hospitalization (up to 28 days) | Proportion of patients receiving systemic antibiotics during the index hospitalization. |
| Duration of antibiotic therapy | Up to 28 days | Total number of days of systemic antibiotic therapy during the index hospitalization. |
| Infected pancreatic necrosis | Up to 28 days | Occurrence of infected pancreatic necrosis confirmed by microbiological culture or strong clinical and radiological evidence requiring intervention. |
| Need for invasive interventions | Up to 28 days | Requirement for invasive interventions including percutaneous drainage or necrosectomy. |
Contacts
CONTACTAbanoob M Asham, Resident
STUDY_CHAIRWael A Abbas, prof
Internal Medicine Department, Assiut University Hospitals
Outcome results
None listed