The comparison of apache ii scores with neutrophil lymphocyte ratio and red cell distribution width for the prediction of prognosis of patients with acute pancreatitis

Acute pancreatitis Acute pancreatitis (AP) is an inflammatory process of pancreatic tissue, which can affect other distant organ systems. Its severity can range from mild inflammation to severe, progressive pancreatic necrosis, and it can lead to multiorgan failure that may have a mortality rate as high as 20% to 30% [1]. Several scoring systems have been proposed to determine its severity. Among these, Balthazar [2,3] and The Early Warning Score (EWS) [4] are calculated from computed tomography findings and physical examination. Other scoring systems (Ranson criteria, APACHE score, Glasgow and Imrie scores), on the other hand, require combined use of clinical and laboratory variables. While definitive diagnosis can be made at the end of 48 hours in Ranson and Imrie scores, The Acute Physiology and Chronic Health Evaluation II (APACHE II) score enables physicians to make prognostic predictions at the time of hospital admission [5]. Therefore, there is an ongoing need for a universally accepted, easy-to-use, and highly sensitive parameter for predicting acute pancreatitis severity. Serum markers as procalcitonin, interleukin-6, and interleukin-8, known to be useful markers for predicting AP severity, cannot be widely used due to their cost, unsuitability for clinical use, and limited availability. Total white blood cell count is a routinely used hematological test that is used in various scoring systems to determine acute pancreatitis severity. NeutrophilLymphocyte ratio (NLR) has been found superior to total white blood cell count for predicting prognosis [6]. Red blood cell distribution width (RDW) reflects erythrocyte distribution volume. Inflammatory markers such as C-reactive protein, erythrocyte sedimentation rate, and IL6 have been linked to increased RDW level [7,8]. This study aimed to compare the efficacy of APACHE II scoring system with Neutrophil Lymphocyte Ratio and RDW level in predicting prognosis of patients with acute pancreatitis.