The Predictive Value Of RPR,NLR Combined With OASIS Score In The Prognosis Of Acute Pancreatitis

Objective To analyze whether the RPR,NLR and OASIS scoring system scores of the patients with acute pancreatitis(AP)in the death group and the survival group were different;To determine whether RPR,NLR and OASIS scoring system scores are independent risk factors affecting the prognosis of patients with acute pancreatitis;According to the area under the ROC curve(AUC),the largest Youden index,the best cut-off value,sensitivity and specificity,to analyze the predictive value of RPR,NLR,OASIS score and the three combined detection in the prognosis of patients with acute pancreatitis.Methods All data were analyzed using SPSS 25.0 statistical software,and Graph Pad Prism8.0 system was used to draw statistical graphs.The measurement data do not conform to the normal distribution,so the measurement data are expressed as median and quartile M(QL,QU).Mann-Whitney U test by Wilcoxon rank sum test was used to compare the two groups.Count data were expressed as percentage of cases(%),and Fisher exact probability method was used for comparison between groups.Binary Logistic multivariate statistical analysis was performed on the different counting and measurement data in the above steps to determine which indicators were independent risk factors affecting the prognosis of patients with acute pancreatitis.RPR,NLR,OASIS and the three combined plots were drawn into receiver operating characteristic curve(ROC curve),and the area under ROC curve(AUC)was calculated.According to the maximum approximate entry index(approximate entry index =sensitivity + specificity-1),the corresponding optimal cut-off value,sensitivity,specificity and95% confidence interval were obtained.To compare the prognostic value of RPR,NLR,OASIS and three combinations in patients with acute pancreatitis.AUC<0.5 indicates that the prediction is completely worthless.AUC has certain predictive value between 0.5 and 0.7.Clinically,it is generally believed that the prediction of the model is more reliable when AUC>0.9,and the greater the predictive value when it is closer to 1,suggesting that it can be applied in clinical guidance.P < 0.05 indicated statistically significant differences.Results 1.In general data,there were differences in the age,length of stay in ICU,type of etiology,and type of first admission to the ICU in patients with acute pancreatitis between the death group and the survival group.The age of the patients in the death group was higher than that in the survival group,and the ICU days of the patients in the death group were more than those in the survival group,and the difference was statistically significant(P<0.05).2.Among the clinical indicators,NLR,RPR,WBC,RBC,Hct,Hb,INR,Scr,Bil,ALT and AST of patients with acute pancreatitis in the death group and the survival group were statistically different(P<0.05).Among them,RBC,Hb and Hct in the death group were lower than those in the survival group,and NLR,RPR,WBC,INR,Scr,Bil,ALT and AST in the death group were higher than those in the survival group.3.In the scoring system,the SOFA,SIRS,SAPS II,LODS,MELD,OASIS,and Charson scores of acute pancreatitis patients in the death group and the survival group were statistically different,and the scores of the death group were higher than those in the survival group(P<0.05).4.Using binary logistic regression analysis,it was found that the length of stay in ICU,Hb,RPR,SOFA,LODS,SIRS and SCr were statistically significant(P<0.05).5.By drawing the ROC curve,the predictive value of RPR,NLR and OASIS scores and the three combined detection on the prognosis of patients with acute pancreatitis was compared.OASIS [AUC=0.911,95%CI(0.883～0.939),P(27)0.05] was better than NLR [AUC=0.63,95%CI(0.575～0.685),P(27)0.05] in predicting the prognosis of patients with acute pancreatitis while RPR [AUC=0.57,95%CI(0.512～0.628),P(27)0.05] had the worst predictive value for the prognosis of patients with acute pancreatitis;the three combined detection had the highest predictive value for the prognosis of patients with acute pancreatitis AUC It was 0.916 [95%CI(0.889～0.944),P(27)0.05],the sensitivity was 91.7%,the specificity was 76.5%,and the best cut-off value was 0.108.6.The ROC curves were drawn for the scores of the seven scoring systems,and the results showed that all the seven scoring systems could be used as indicators to predict the prognosis of patients with acute pancreatitis.Among them,the SOFA scoring system has the greatest predictive value for the prognosis of patients with acute pancreatitis,with an AUC of 0.933,[95% CI(0.912-0.953),P(27)0.05],a sensitivity of 85%,a specificity of 85.8%,and the best cut-off value of 9.5 point.The highest sensitivity of LODS for the predictive value of prognosis in patients with acute pancreatitis was 89.2%.Compared with other scoring systems,the SIRS score had the worst predictive value and the lowest sensitivity(45.8%)for the prognosis of patients with acute pancreatitis.Conclusions Higher RPR,higher NLR,and higher OASIS scores indicate poor prognosis in patients with acute pancreatitis.RPR is an independent risk factor affecting the prognosis of patients with acute pancreatitis.RPR,NLR and OASIS can be used as indicators to predict the prognosis of patients with acute pancreatitis,and the combined detection of the three indicators has the greatest predictive value for the prognosis of patients with acute pancreatitis.