S9 Serum Biomarkers Ratios as Prognostic Factors in Acute Pancreatitis

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Introduction: Acute pancreatitis (AP) is a severe abdominal disorder characterized by sudden onset, rapid progression, and high mortality. Currently, we use the Acute Physiology and Chronic Health Evaluation II Score (APACHE II) and Ranson's Criteria to determine the severity of AP. However, these tools require multiple factors. Thus, a more straightforward and quick option is needed for predicting disease severity. The lymphocytes-neutrophil ratio (LNR), platelet-to-albumin ratio (PAR), and other serum biomarker ratios represent easily reproducible markers that may predict the outcomes of various diseases. We aim to assess the prognostic value of these ratios in AP. Methods: This study was reviewed and approved by the University of Pittsburgh Medical Center of Central Pennsylvania Review Board. Using Epic’s SlicerDicer function, patients with acute pancreatitis admitted were identified. Those with incomplete information or duplicated were excluded obtaining a total of 78 patients. We reported continuous variables as mean (range) and categorical variables as number (percent). We used a cut-off determined by using a receiver operating characteristic (ROC) curve. We used Student’s t-test to analyze between-group differences for the continuous variables. Results: Seventy-8 patients were admitted with acute pancreatitis. Regarding etiology, 30% were alcohol-related, 10% were gallstone-related, and no clear cause was found in 38.4% of patients. Other demographic information can be found in Table 1. Eight patients (10.3%) died, 5 were readmitted, and 10 patients (12.8%) needed ICU admission. ROC analysis and Youden’s J-point suggested that the optimal cut-off values of RDW/Albumin ratio and Hemoglobin/RDW ratio showed significant differences in mortality of patients admitted with acute pancreatitis. For the RDW/Albumin ratio, the cut-off value was 0.5214 (AUC: 0.713, P=0.05) with a sensitivity of 75% and specificity of 77.14%. And in the case of the Hemoglobin/RDW ratio, the cut-off values were 0.4321 (AUC: 0.691, P=0.019) with a sensitivity of 87.5% and specificity of 55.71%. Conclusion: RDW/Albumin and Hemoglobin/RDW ratios showed a significant difference in predicting mortality in patients admitted with acute pancreatitis (see Figure 1, Table 1).Figure 1.: ROC analysis representing the prognostic value for prognosis for RDW/Albumin ratio and Hemoglobin/RDW ratio in patients admitted with acute pancreatitis. Table 1. - Demographics and Outcomes Etiology Alcoholic 24 30.80% Gallstone 24 30.80% Other 30 38.40% Female 47 60.30% Age 54.6 +/- 20.6 Comorbidities Hypertension 46 59.00% Diabetes 35 44.90% Cirrhosis 32 41.00% Smoking 44 56.40% Alcohol use 35 44.90% Outcomes Deceased 8 10.30% Readmitted 5 6.40% Needed ICU 10 12.80% Length stay in ICU 5.5 days Ratios - mean Lymph/Neutroph ratio 0.372 Neutrophil/lymph ratio 8.518 AST/ALT ratio 1.278 AST/ALP ratio 1.291 RDW/Albumin ratio 3.694 Hgb/albumin 3.381 Platelet/albumin ratio 61.631 Hemoglobin/RDW ratio 0.957

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