Silva-Vaz et al reported biomarkers and scores associated with severe pancreatitis in a patient with acute biliary pancreatitis. These can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in Portugal.
Patient selection: acute biliary pancreatitis
Parameters associated with severe pancreatitis:
(1) white blood cell count per µL
(2) neutrophil to lymphocyte ratio (NLR)
(3) serum procalcitonin in ng/mL
(4) serum hepcidin in ng/mL
(5) BISAP score
(6) systemic inflammatory response syndrome (SIRS)
(7) modified Marshall score (mMS)
(8) systemic inflammatory response index (SIRI)
(9) platelet to lymphocyte ratio (PLR)
(10) serum CRP in mg/dL
Tests on Admission
Cutoff
WBC count
>= 14,880 per µL
NLR
>= 14.64
procalcitonin
>= 0.58 ng/mL
hepcidin
>= 72.8 ng/mL
BISAP
>= 3
SIRS
>= 2
modified Marshall score
>= 2
Tests 48 Hours After Admission
Cutoff
WBC count
>= 12,090 per µL
NLR
>= 10.89
procalcitonin
>= 2.83 ng/mL
hepcidin
>= 154.7 ng/mL
BISAP
>= 3
SIRS
>= 2
modified Marshall score
>= 2
SIRI
>= 7.14
PLR
>= 187.8
CRP
>= 1.5 mg/dL
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