Predictive Value Of NLR Combined With Three Different Scoring Systems In Predicting Adult Severe Acute Pancreatitis In ICU

[Objective]To explore the clinical predictive value of neutrophil lymphocyte ratio(NLR)combined with early APACHE Ⅱ score,BISAP score and SOFA score in the prognosis of adult patients with severe acute pancreatitis(SAP)in ICU.[Methods]In this retrospective,observational study,we collected the early(nearly within 24 hours)clinical and laboratory data of adult patients with severe acute pancreatitis,admitted to ICU,in the first affiliated Hospital of Kunming Medical University,from 1st January,2016 to 31th December,2018(n=75).Patients were divided into survival group(n=60)and death group(n=15),according to their prognosis at discharge.The patients’ general condition,laboratory data,NLR,APACHE Ⅱ score,BISAP score,SOFA score are analyzed by the service solution software package.and we compare the area under the curve(AUC)of the receiver operating characteristic(ROC)curve of the NLR,the APACHE Ⅱ score,the BISAP score,SOFA score,and NLR combine with the APACHE Ⅱ score,the BISAP score and SOFA score.To analysis the clinical predictive value of neutrophil lymphocyte ratio(NLR)combined with three scores in the prognosis of patients with severe acute pancreatitis(SAP)in ICU[Results]1.The mean values of APCHEⅡ score,BISAP score,SOFA score,and NLR in the death group were 17.27,3.40,8.80,and 17.74.The mean values of APCHE II score,BISAP score,SOFA score and NLR in the survival group were 10.63,2.47,5.70 and 10.53.There were statistically significant difference between the two groups in APACHE Ⅱ score,BISAP score,SOFA score,and NLR(p<0.05).According to the ROC curve,the AUC of the APACHE II score,BISAP score,SOFA score and NLR were 0.830,0.793,0.727 and 0.776,the sensitivities were 73.33%,86.67%,53.33%and 80.00%,the specificities were 76.67%,56.67%,83.33%and 73.33%,in predicting the prognosis of patients.2.According to the ROC curve,the AUC of NLR+APACHE II score,NLR+BISAP score and NLR+SOFA score were 0.85、0.832 and 0.776,the sensitivity were 80.00%,80.00%and 60.00%,the specificity is 76.67%,83.33%and 93.33%,in predicting the prognosis of the patients.3.There was a statistical difference(P<0.05)between BUN,Cys-c,Ca2+,TG and PCT within 24 hours between the survival group and the death group.[Conclusion]1.When NLR≥11.99,it can be used to predict the prognosis of adult patients with severe acute pancreatitis in ICU,compared with the three scores,the predictive value order is APCHE II score>BISAP score>NLR>SOFA score.2.NLR combined with APACHE II score,BISAP score,SOFA score can improve the accuracy of predicting the prognosis of patients with severe acute pancreatitis in ICU.