Effect of harmless acute pancreatitis score, red cell distribution width and neutrophil/lymphocyte ratio on the mortality of patients with nontraumatic acute pancreatitis at the emergency department

doi:10.5847/wjem.j.1920-8642.2015.01.005

Abstract

Abstract:

BACKGROUND: Harmless acute pancreatitis score (HAPS), neutrophile/lymphocyte ratio and red blood cell distribution width (RDW) are used to determine the early prognosis of patients diagnosed with nontraumatic acute pancreatitis in the emergency department (ED).
METHODS: Patients diagnosed with acute pancreatitis (K 85.9) in the ED according to the ICD10 coding during one year were included in the study. Patients with chronic pancreatitis and those who had missing data in their files were excluded from the study. Patients who did not have computed tomography (CT) in the ED were not included in the study.
RESULTS: Ultimately, 322 patients were included in the study. The median age of the patients was 53.1 (IQR=36-64). Of the patients, 68.1% (n=226) had etiological causes of the biliary tract. The mortality rate of these patients within the first 48 hours was 4.3% (n=14). In the logistic regression analysis performed by using Balthazar classification, HAPS score, RDW, neutrophile/lymphocyte ratio, age, diabetes mellitus and systolic blood pressure, the only independent variable in determining mortality was assigned as Balthazar classification (OR: 15; 95% CI: 3.5 to 64.4).
CONCLUSIONS: HAPS, neutrophile/lymphocyte ratio and RDW were not effective in determining the mortality of nontraumatic acute pancreatitis cases within the first 48 hours. The only independent variable for determining the mortality was Balthazar classification.

Key words: Acute pancreatitis, Mortality, Balthazar, Emergency department

Bedia Gülen, Ertan Sonmez, Serpil Yaylaci, Mustafa Serinken, Cenker Eken, Ali Dur, Figen Tunali Turkdogan, Özgür Söğüt. Effect of harmless acute pancreatitis score, red cell distribution width and neutrophil/lymphocyte ratio on the mortality of patients with nontraumatic acute pancreatitis at the emergency department[J]. World Journal of Emergency Medicine, 2015, 6(1): 29-33.

Figures/Tables 2

Table 1

Table 2

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Variables	% (n)
Gender
Female	63.8 (212)
Complaint on admission
Epigastric pain	70.7 (235)
Abdominal pain	28.0 (93)
No pain	1.3 (4)
Defense	28.9 (96)
Rebound	9.9 (33)
Diabetes mellitus	29.3 (97)
Hypertension	30.6 (101)
Coronary artery disease	0.8 (36)
Malignancy	3.0 (10)
Etiology of pancreatitis
Biliary	68.1 (226)
Alcholic	14.0 (46)
Other	6.1 (21)
Idiopathic	11.8 (39)
Grade (Balthazar)
A	13.8 (46)
B	18.1 (60)
C	28.4 (94)
D	20.7 (69)
E	19.0 (63)
Mortality	4.3 (14)

Variables	Mortality - median (IQR)	Mortality + median (IQR)	Pvalue
Systolic TA	125 (110-140)	121 (119-167)	0.800
Diastolic TA	73 (67-80)	67 (58-77)	0.151
Pulse	82 (76-89)	97 (83-102)	0.086
Creatinin	0.7 (0.6-1.0)	1.0 (0.8-1.2)	0.091
Amylase	931 (271-2329)	2011 (556-2950)	0.406
Lipase	1209 (386-2921)	1353 (565-5506)	0.751
Glucose	130 (104-173)	177 (124-248)	0.238
WBC	11.6 (9.1-15.1)	9.6 (8.4-13.6)	0.457
Neutrophile	78.2 (68.0-85.0)	80.8 (69.4-87.3)	0.075
Lymphocyte	13.4 (9.6-20.4)	8.5 (6.9-22.8)	0.091
Neutrophil/lymphocyte	5.77 (3.49-8.58)	9.99 (3.50-12.54)	0.041^*
PTL	238 (199-285)	193 (124-283)	0.108
RDW	13.7 (12.9-14.5)	14.7 (13.7-15.6)	0.201
Hg	13.3 (12.1-14.5)	13.2 (11.8-14.4)	0.590
Htc	39.5 (36.5-42.5)	42.3 (37.5-42.7)	0.637

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