Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

EndNote Style
Original Article
Predictive factors for acute pancreatic and peripancreatic fluid development in patients with acute pancreatitis
Aims: Acute fluid collections after acute pancreatitis carries risk of serious complications as infected pseudocyst and Wall off Necrose development. Hence, it is important to predict the development of acute fluid collections for treatment and management of acute pancreatitis. In this study, it is aimed to investigate predictive factors for development of acute fluid collections in patients with acute pancreatitis.
Methods: Total of 438 patients diagnosed with acute pancreatitis were screened. According to the Revised Atlanta Classification fluid development after acute pancreatitis was determined and the relationship between fluid development and the hematological/biochemical parameters of the patients at the time of admission was investigated. The best cut-off point of laboratory measurements for fluid development was determined by ROC analysis and the factors that may be most decisive in distinguishing between the patients with and without fluid development were determined by multivariate forward stepwise logistic regression analysis.
Results: It is found that developing acute fluid collections after acute pancreatitis was higher in patients with younger age and male gender. Also the risk of developing acute fluid collections after acute pancreatitis was found to be 6.2 times higher in patients with CRP/Albumin ratio greater than 1.09; 2.5 times higher in patients with ALP below 199.5 U/L; 1.9 times higher in patients with WBC greater than 11,6 ×10?/L and 1.5 times higher in patients with PLR above 197.1. Also the risk of developing acute necrotic collections after acute pancreatitis was 3 times higher in patients with serum calcium level below 8,6 mg/dl.
Conclusion: It has been determined that, presence of high CRP/albumin ratio, high NLR and low serum ALP level can be used as an indicator in predicting acute pancreatic and peripancreatic fluid development.

1. Cui ML, Kim KH, Kim HG, et al. Incidence, risk factors andclinical course of pancreatic fluid collections in acute pancreatitis.Dig Dis Sci. 2014;59(5):1055-1062.
2. Guzmán-Calderón E, Diaz-Arocutipa C, Monge E. Lactateringer’s versus normal saline in the management of acutepancreatitis: a systematic review and meta-analysis of randomizedcontrolled trials. Dig Dis Sci. 2022;67(8):4131-4139.
3. Heckler M, Hackert T, Hu K, Halloran CM, Büchler MW,Neoptolemos JP. Severe acute pancreatitis: surgical indicationsand treatment. Langenbecks Arch Surg. 2021;406(3):521-535.
4. Matta B, Gougol A, Gao X, et al. Worldwide variations indemographics, management, and outcomes of acute pancreatitis.Clin Gastroenterol Hepatol. 2020;18(7):1567-1575.
5. Diculescu M, Ciocîrlan M, Ciocîrlan M, Stanescu D,Ciprut T, Marinescu T. Predictive factors for pseudocystsand peripancreatic collections in acute pancreatitis. Rom JGastroenterol. 2005;14(2):129-134.
6. Poornachandra KS, Bhasin DK, Nagi B, et al. Clinical, biochemical,and radiologic parameters at admission predicting formationof a pseudocyst in acute pancreatitis. J Clin Gastroenterol.2011;45(2):159-163.
7. Banks PA, Bollen TL, Dervenis C, et al. Acute PancreatitisClassification Working Group. classification of acutepancreatitis-2012: revision of the Atlanta classification anddefinitions by international consensus. Gut. 2013;62(1):102-111.
8. Eguchi T, Tsuji Y, Okada A, et al. Reducing the risk of developingwalled-off necrosis in patients with acute necrotic collection usingrecombinant human soluble thrombomodulin. J HepatobiliaryPancreat Sci. 2021;28(9):788-797.
9. Iannuzzi JP, King JA, Leong JH, et al. Global incidence of acutepancreatitis is increasing over time: a systematic review andmeta-analysis. Gastroenterol. 2022;162(1):122-134.
10. Tan JH, Zhou L, Cao RC, Zhang GW. Identification of riskfactors for pancreatic pseudocysts formation, intervention andrecurrence: a 15-year retrospective analysis in a tertiary hospitalin China. BMC Gastroenterology. 2018;18(1):143.
11. Manrai M, Kochhar R, Gupta V, et al. Outcome of acutepancreatic and peripancreatic collections occurring in patientswith acute pancreatitis. Ann Surg. 2018;267(2):357-363.
12. Stamatakos M, Stefanaki C, Kontzoglou K, Stergiopoulos S,Giannopoulos G, Safioleas M. Walled-off pancreatic necrosis.World J Gastroenterol. 2010;16(14):1707-1712.
13. Ramia JM, de la Plaza R, Quiñones-Sampedro JE, Ramiro C,Veguillas P, García-Parreño J. Walled-off pancreatic necrosis.Neth J Med. 2012;70(4):168-171.
14. Akgül Ö, Ersöz Ş, Şenol K, Gündoğdu SB, Çetinkaya E, Tez M.Calcium level may be a predictive factor for pseudocyst formationafter acute pancreatitis. Acta Gastroenterol Belg. 2015;78(2):219-222.
15. Lin CT, McKenzie M, Pell J, Caplan L. Hypertriglyceridemia andacute pancreatitis. JAMA Inter Med. 2013;173(2):160-162.
16. Carr RA, Rejowski BJ, Cote GA, Pitt HA, Zyromski NJ. Systematicreview of hypertriglyceridemia-induced acute pancreatitis: amore virulent etiology? Pancreatol. 2016;16(4):469-476.
17. Frick TW. The role of calcium in acute pancreatitis. Surg.2012;152(3):157-163.
18. Valverde-López F, Matas-Cobos AM, Alegría-Motte C, Jiménez-Rosales R, Úbeda-Muñoz M, Redondo-Cerezo E. BISAP,RANSON, lactate and others biomarkers in prediction of severeacute pancreatitis in a European cohort. J Gastroenterol Hepatol.2017;32(9):1649-1656.
19. Lallès JP. Recent advances in intestinal alkaline phosphatase,inflammation, and nutrition. Nutr Rev. 2019;77(10):710-724.
20. Fawley J, Gourlay DM. Intestinal alkaline phosphatase: a summaryof its role in clinical disease. J Surgic Res. 2016;202(1):225-234.
21. Yarkaç A, Kose A, Bozkurt Babuş S, Ates F, Orekici Temel G,Ölmez A. Akut pankreatitte hematolojik parametrelerin değeri.Ulus Travma Acil Cerrahi Derg. 2019;25(5):453-460.
22. Kong W, He Y, Bao H, Zhang W, Wang X. Diagnostic valueof neutrophil-lymphocyte ratio for predicting the severityof acute pancreatitis: a meta-analysis. Disease Markers.2020;2020:9731854.
23. Kaplan M, Ates I, Oztas E, et al. A new marker to determineprognosis of acute pancreatitis: PLR and NLR combination. JMed Biochemis. 2018;37(1):21-30.
24. Dancu GM, Popescu A, Sirli R, et al. The BISAP score, NLR,CRP, or BUN: which marker best predicts the outcome of acutepancreatitis? Medicine. 2021;100(51):E28121.
25. Cho SK, Jung S, Lee KJ, Kim JW. Neutrophil to lymphocyteratio and platelet to lymphocyte ratio can predict the severity ofgallstone pancreatitis. BMC Gastroenterol. 2018;18(1):18.
26. Werner J, Hartwig W, Uhl W, Müller C, Büchler MW. Usefulmarkers for predicting severity and monitoring progression ofacute pancreatitis. pancreatology. Elsevier B V. 2003;3(2):115-127.
27. Kandasamy S. Is it all clear if procalcitonin clears in acutepancreatitis? Indian J Critic Care Med. 2020;24(3):149-150.
28. Clyne B, Olshaker JS. The C-reactive protein. J Emerg Med.1999;17(6):1019-1025.
29. Stirling AD, Moran NR, Kelly ME, Ridgway PF, Conlon KC. Thepredictive value of C-reactive protein (CRP) in acute pancreatitis- is interval change in CRP an additional indicator of severity?HPB. 2017;19(10):874-880.
30. Vinish DB, Abishek V, Sujatha K, Arulprakash S, Solomon R,Ganesh P. Role of bedside pancreatic scores and C-reactiveprotein in predicting pancreatic fluid collections and necrosis.Indian J Gastroenterol. 2017;36(1):43-49.
31. Bozkurt E, Muhafiz E, Sengul D, Uçak T, Atum M. Can the CRP/albumin ratio be used as a new indicator of activation in patientswith uveitis? Ocular Immun Inflammat. 2021;29(5):1017-1022.
32. Gibson DJ, Hartery K, Doherty J, et al. CRP/Albumin ratio: anearly predictor of steroid responsiveness in acute severe ulcerativecolitis. J Clin Gastroenterol. 2018;52(6):48-52.
33. Kaplan M, Ates I, Akpinar MY, et al. Predictive value ofC-reactive protein/albumin ratio in acute pancreatitis. HepatobilPancr Diseas Int. 2017;16(4):424-430.
34. Yılmaz EM, Kandemir A. Significance of red blood celldistribution width and c-reactive protein/albumin levels inpredicting prognosis of acute pancreatitis. Ulus Trav Acil CerrahiDerg. 2018;24(6):528-531.
Volume 4, Issue 6, 2023
Page : 630-636