Giá trị của một số chỉ số huyết học trong tiên lượng mức độ nặng của viêm tụy cấp

Acute pancreatitis (AP) is an inflammatory condition of the pancreas that can range from mild to severe, potentially leading to significant morbidity and mortality. Early and accurate assessment of disease severity is paramount for effective patient management and intervention. While advanced imaging techniques provide crucial information, they can be time-consuming and not always immediately available. Consequently, there is a growing interest in identifying simple, readily accessible, and cost-effective hematological indices that can aid in the early prognostication of AP severity. This study aims to investigate the predictive value of specific blood cell ratios, such as the Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR), in determining the severity of acute pancreatitis, thereby contributing to improved clinical decision-making.

Gastroenterologists, emergency physicians, intensivists, clinical pathologists, medical residents, and researchers interested in the diagnosis and prognosis of acute pancreatitis.

This cross-sectional descriptive study examined the role of various hematological indices in predicting the severity of acute pancreatitis (AP) among 104 patients treated at Hanoi Medical University Hospital between January and June 2024. Patients were categorized by AP severity using the Computed Tomography Severity Index (CTSI). The research found a significant correlation between increasing AP severity and longer hospital stays. Crucially, several blood parameters, including neutrophil percentage (Neut%), lymphocyte percentage (Lymp%), Neutrophil-to-Lymphocyte Ratio (NLR), and Platelet-to-Lymphocyte Ratio (PLR), exhibited statistically significant differences across different CTSI severity groups (p<0.05). Both NLR and PLR demonstrated promising predictive capabilities for AP severity, evidenced by Area Under the Curve (AUC) values of 0.681 and 0.645, respectively, outperforming the predictive ability of white blood cell count (AUC=0.598). Additionally, C-reactive protein (CRPhs) also showed significant variation with disease severity (p=0.018). These findings highlight that NLR and PLR, as readily available and simple blood tests, can serve as valuable, cost-effective prognostic tools to more accurately assess AP severity. Their application can facilitate earlier risk stratification, allowing for more timely and appropriate clinical interventions, potentially improving patient outcomes and resource allocation, especially in settings where advanced imaging might be delayed.