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23.02.2021 | original article | Ausgabe 13-14/2021

Wiener klinische Wochenschrift 13-14/2021

Complete hemogram: simple and cost-effective in staging and predicting outcome in acute pancreatitis

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 13-14/2021
Autoren:
Dr. Parmeshwar Ramesh Junare, Dr. Prasanta Debnath, Dr. Sujit Nair, Dr. Sanjay Chandnani, Dr. Suhas Udgirkar, Dr. Ravi Thange, Dr. Shubham Jain, Dr. Rahul Deshmukh, Dr. Partha Debnath, Dr. Pravin Rathi, Dr. Qais Contractor, Dr. Akshay Deshpande
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Summary

Background

An important goal in management of acute pancreatitis (AP) is early prediction and recognition of disease severity. Various predictive scoring systems are in clinical use with their own limitations and there is always a quest for simple, practical, quantifiable, dynamic and readily available markers for predicting disease severity and outcome. Complete hemogram is routinely ordered in all patients with AP. In recent years red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR) and platelet lymphocyte ratio (PLR) have been found to be independent predictors of prognosis in various benign and malignant conditions. This prospective study evaluated complete hemogram based markers in AP.

Material and methods

Complete hemogram analysis was done and NLR, LMR, PLR values were calculated. Development of organ failure, the need for intensive care unit (ICU) admission and interventions, development of complications (local/systemic) and 100-day mortality were assessed.

Results

In this study 160 subjects of AP were included. Complete hemogram analysis was performed within 24 h after admission. C‑reactive protein, RDW, NLR, PLR and bedside index of severity in acute pancreatitis (BISAP) values were higher in severe AP than moderate AP group than mild AP group, while LMR values were decreased in the corresponding severe, moderate and mild AP groups (p < 0.001). The NLR performed best for prediction of ICU admission, organ failure, interventions and mortality with area under receiver operating curve (AUROC) were 0.943, 0.940, 0.902 and 0.910, respectively.

Conclusion

Hemogram based markers are simple, objective, dynamic and readily available. They can be considered in addition to conventional multifactorial scoring systems for prediction of outcome and prognosis of AP.

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