The Prognostic Importance of the Count and Percentage of Immature Granulocytes in the Determination of the Severity of Acute Pancreatitis

Abstract

AIM: Acute pancreatitis (AP) is a disease with high rates of morbidity and mortality. As the severity of pancreatitis increases, the risk of mortality also rises; however, there is still no definitive marker for the early determination of pancreatitis severity. The aim of this study was to investigate the value of immature granulocytes (IG) count and percentage (IG%) in diagnosing the disease, determining the severity, and predicting mortality in AP patients.

METHODS: The records were retrospectively scanned of patients admitted to our hospital because of AP between January 2022 and March 2023. The patients were analyzed by classification into 3 groups of mild, moderate, and severe pancreatitis according to the modified Atlanta criteria.

RESULTS: Evaluation was made of a total of 163 patients, comprising 93 females and 70 males with a mean age of 55.78 ± 20.11 years. In the Receiver Operating Characteristic (ROC) analysis performed to determine disease severity, a cut-off value of 0.65% for IG% was found to have Area Under the Curve (AUC): 0.975, 100% sensitivity, 87.5% specificity, 36.7% Positive Predictive Value (PPV), and 100% Negative Predictive Value (NPV) (p < 0.001). IG% was more effective in determining the disease than Lactate Dehydrogenase (LDH) and C-reactive protein (CRP) (p = 0.012, p = 0.001, respectively). In the ROC analysis performed to determine mortality, a cut-off value of 0.55% for IG% was found to have AUC: 0.945, 100% sensitivity, 78.3% specificity, 14.6% PPV, and 100% NPV (p < 0.001).

CONCLUSIONS: The amount and percentage of immature granulocytes is an effective predictive marker in the diagnosis of acute pancreatitis, determination of disease severity, and prediction of mortality.