Abstract
Several inflammation-related factors (IRFs) have been reported to predict organ failure of acute pancreatitis (AP) in previous clinical studies. However, there are a few shortcomings in these models. The aim of this study was to develop a new prediction model based on IRFs that could accurately identify the risk for organ failure in AP. Methods. 100 patients with their clinical information and IRF data (levels of 10 cytokines, percentages of different immune cells, and data obtained from white blood cell count) were retrospectively enrolled in this study, and 94 patients were finally selected for further analysis. Univariate and multivariate analysis were applied to evaluate the potential risk factors for the organ failure of AP. The area under the ROC curve (AUCs), sensitivity, and specificity of the relevant model were assessed to evaluate the prediction ability of IRFs. A new scoring system to predict the organ failure of AP was created based on the regression coefficient of a multivariate logistic regression model. Results. The incidence of OF in AP patients was nearly 16% (15/94) in our derivation cohort. Univariate analytic data revealed that IL6, IL8, IL10, MCP1, CD3+ CD4+ T lymphocytes, CD19+ B lymphocytes, PCT, APACHE II score, and RANSON score were potential predictors for AP organ failure, and IL6 (P = 0.038), IL8 (P = 0.043), and CD19+B lymphocytes (P = 0.045) were independent predictors according to further multivariate analysis. In addition, a preoperative scoring system (0-11 points) was constructed to predict the organ failure of AP using these three factors. The AUC of the new score system was 0.86. The optimal cut-off value of the new scoring system was 6 points. Conclusions. Our prediction model (based on IL6, IL8, and CD19+ B Lymphocyte) has satisfactory working efficiency to identify AP patients with high risk of organ failure.
Highlights
Acute pancreatitis (AP) commonly presents as a mild and self-limiting course with slighter clinical symptoms
In the early stage of acute pancreatitis (AP), Mediators of Inflammation abundant cytokines induced by local pancreatic inflammation enter the bloodstream and further cause systemic inflammatory response syndrome (SIRS) by “trigger effect,” which eventually leads to organ failure [5]
A total of 100 patients were enrolled in this study, 94 patients were enrolled in the statistical analysis, and 6 patients were excluded due to the lack of inflammation-related factors (IRFs) data (3 patients for PCT, 1 patient for C-reactive protein (CRP), 2 patients for PCT and CRP)
Summary
Acute pancreatitis (AP) commonly presents as a mild and self-limiting course with slighter clinical symptoms. Organ failure typically develops early in the course of acute pancreatitis and may develop later due to infected pancreatic necrosis-induced sepsis. In the early stage of acute pancreatitis (AP), Mediators of Inflammation abundant cytokines induced by local pancreatic inflammation enter the bloodstream and further cause SIRS by “trigger effect,” which eventually leads to organ failure [5]. The most commonly used inflammation biomarkers in clinical practice, C-reactive protein (CRP) and PCT, play similar roles in the early prediction of APrelated OF [8, 9]. It has been reported that patients with early elevated levels of CRP and PCT tended to suffer with organ failure in several studies [10]
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