South Clin Ist Euras. 2023; 34(2): 131-137 | DOI: 10.14744/scie.2023.70893

Diagnostic Value of Systemic Immune-inflammation Index in Patients with Acute Pancreatitis

Ertuðrul Altuð¹, Adem Çakýr², Hüseyin Kýlavuz³, Kemal Þener¹, Gökhan Eyüpoðlu¹, Ramazan Güven^1
1Baþakþehir Çam and Sakura City Hospital, Department of Emergency Medicine, Ýstanbul, Türkiye
²Ministry of Healthy of Turkey Canakkale Mehmet Akif Ersoy State Hospital, Department of Emergency Medicine, Çanakkale, Türkiye
³Baþakþehir Çam and Sakura City Hospital, Department of General Surgery, Ýstanbul, Türkiye

INTRODUCTION: Acute pancreatitis is one of the most common causes of gastrointestinal dis-eases. Furthermore, it is a very common disease diagnosed in the emergency department (ED). However, the diagnosis of acute pancreatitis cannot be made with simple and inexpensive methods in the ED. The systematic immune-inflammation index (SII) is a scoring system that has recently been introduced for diagnosing inflammatory diseases. This study investigates the use of SII in diagnosing acute pancreatitis and predicting its severity.
METHODS: This study was carried out retrospectively, in a single center, in the ED of a tertiary education and research hospital. The study included patients who presented to the ED between June 2021 and December 2021 and were diagnosed with acute pancreatitis and who met the inclusion criteria. Of 207 patients diagnosed with acute pancreatitis, 150 patients who met the inclusion criteria were included in the study.
RESULTS: Comparison of SII and neutrophil-to-lymphocyte ratio (NLR) in diagnosing pancreatitis and predicting its severity showed that SII with a cutoff value of 938.82×109/L had 78.7% sensitivity and 46% specificity in diagnosing pancreatitis (area under the curve [AUC]: 0.685; 95% confidence interval [CI]: 0.626–0.745). NLR, with a cutoff value of 4.45, on the other hand, had 74.7% sensitivity and 50% specificity in diagnosing pancreatitis (AUC: 0.677; 95% CI: 0.617–0.737). SII performed better than NLR in diagnosing acute pancreatitis.
DISCUSSION AND CONCLUSION: SII is more sensitive in the diagnosis of acute pancreatitis, and NLR is more sensitive in disease severity. SII can be used in the diagnosis of acute pancreatitis.

Keywords: Acute pancreatitis, neutrophil–lymphocyte ratio; systemic immune-inflammatory index

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Akut Pankreatitte Sistemik Ýmmün-Ýnflamasyon Ýndeksinin Tanýsal Deðeri

Ertuðrul Altuð¹, Adem Çakýr², Hüseyin Kýlavuz³, Kemal Þener¹, Gökhan Eyüpoðlu¹, Ramazan Güven^1
1Baþakþehir Çam ve Sakura Þehir Hastanesi, Acil Týp Kliniði
²Türkiye Saðlýk Bakanlýðý Çanakkale Mehmet Akis Ersoy Devlet Hastanesi, Acil Týp
³Baþakþehir Çam ve Sakura Þehir Hastanesi, Genel Cerrahi Kliniði

GÝRÝÞ ve AMAÇ: Akut pankreatit, gastrointestinal hastalýklarýn en yaygýn nedenlerinden biridir. Ayrýca, acil serviste (AS) teþhis edilen çok yaygýn bir hastalýktýr. Ancak acil serviste basit ve ucuz yöntemlerle akut pankreatit tanýsý konulamamaktadýr. Sistematik immün-enflamasyon indeksi (SII), enflamatuvar hastalýklarýn teþhisi için son zamanlarda tanýtýlan bir puanlama sistemidir. Bu çalýþma, SII’nin akut pankreatit tanýsýnda ve ciddiyetini tahmin etmede kullanýmýný araþtýrmaktadýr.
YÖNTEM ve GEREÇLER: Bu, üçüncü basamak bir hastanenin acil servisinde yapýlan retrospektif ve tek merkezli bir çalýþmadýr. Çalýþmaya Haziran 2021-Aralýk 2021 tarihleri arasýnda acil servise baþvuran, akut pankreatit tanýsý alan ve dahil edilme kriterlerini karþýlayan hastalar alýndý. Akut pankreatit tanýsý alan 207 hastadan dahil edilme kriterlerini karþýlayan 150 hasta çalýþmaya alýndý.
BULGULAR: Pankreatit tanýsýnda ve þiddetini tahmin etmede SII ve nötrofil-lenfosit oranýnýn (NLO) karþýlaþtýrýlmasý, 938.82×109/L kesme deðeri olan SII’nin pankreatit (alan) tanýsýnda %78.7 duyarlýlýða ve %46 özgüllüðe sahip olduðunu gösterdi. Eðrinin altýnda (EAA): 0.685; %95 güven aralýðý (CI): 0.626–0.745). Kestirim deðeri 4.45 olan NLO ise pankreatit tanýsýnda %74.7 duyarlýlýða ve %50 özgüllüðe sahipti (EAA: 0.677; %95 GA: 0.617–0.737). SII, akut pankreatit tanýsýnda NLR’den daha iyi performans gösterdi.
TARTIÞMA ve SONUÇ: SII, akut pankreatit tanýsýnda NLR’den daha fazla duyarlýlýk göstermektedir. Ancak hastalýðýn ciddiyetini belirlemede NLR daha duyarlýdýr. Sonuç olarak SII acil serviste akut pankreatit tanýsýnda kullanýlabilir.

Anahtar Kelimeler: Akut pankreatit, nötrofil-lenfosit oraný; sistemik immün enflamatuvar indeks.

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