Predictive value of PCT/PLT and CRP/ALB in severe acute pancreatitis and associated liver injury
10.3760/cma.j.issn.1671-0282.2024.10.005
- VernacularTitle:PCT/PLT和CRP/ALB对重症急性胰腺炎及并发肝损伤的预测价值
- Author:
Mengwei CUI
1
;
Qianqian HE
;
Haifeng WANG
;
Huihui LI
;
Jiye LI
;
Zongchao CUI
;
Qiaofang WANG
;
Sanyang CHEN
;
Changju ZHU
Author Information
1. 郑州大学第一附属医院急诊医学部,郑州 450052
- Keywords:
Procalcitonin;
C-reactive protein;
Acute pancreatitis;
Acute liver injury;
Rrisk factors
- From:
Chinese Journal of Emergency Medicine
2024;33(10):1369-1375
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of procalcitonin to platelet ratio (PPR) and C-reactive protein to albumin ratio (CAR) in severe acute pancreatitis (SAP) and the value of SAP and concomitant acute liver injury (ALI).Methods:Total of 195 patients with AP from June 2021 to December 2022 from 374 patients were screened for inclusion in the study and were divided into non-severe acute pancreatitis (NSAP) and SAP groups. The ALI group was divided into non-acute liver injury (NALI) and ALI groups according to ALI criteria, and then into hepatocellular ALI subgroup, cholangiocellular ALI subgroup and mixed ALI subgroup. Laboratory tests for procalcitonin (PCT), C-reactive protein (CRP), albumin and platelet (PLT) were completed within 48 h. Risk factors for SAP, ALI and each subgroup of ALI were analysed by binary logistic regression. Subject work characteristic (ROC) curves were plotted and the optimal thresholds for PPR and CAR were calculated. The predictive value of PPR, CAR and their combination for SAP, ALI and each type of ALI was determined.Results:The AUCs for predicting SAP by plotting ROC curves and calculating the bedside index score of acute pancreatitis severity (BISAP score), PPR, CAR, PPR combined with CAR, PPR combined with BISAP score, CAR combined with BISAP score and combined PPR, CAR and BISAP score were 0.82, 0.85, 0.79 and 0.86. The areas under the ROC curves for PPR, CAR and combined prediction of ALI were 0.81, 0.85 and 0.88, respectively; the areas under the ROC curves for PPR, CAR and combined prediction of hepatocellular ALI were 0.93, 0.77 and 0.92, respectively; and the areas under the ROC curves for PPR, CAR and combined prediction of cholangiocellular ALI were 0.76, 0.76 and 0.77, respectively. The area under the ROC curves for PPR, CAR and combined prediction of mixed ALI were 0.83, 0.76 and 0.82Conclusions:Elevated PPR and CAR are risk factors for SAP and for the development of ALI in AP. PPR has better predictive value than CAR for hepatocellular and mixed ALI, and CAR has better predictive value than PPR for cholangiocellular ALI.
