Ulus Travma Acil Cerrahi Derg. 2019; 25(2): 177-182 | DOI: 10.14744/tjtes.2019.70679

Role of increased immature granulocyte percentage in the early prediction of acute necrotizing pancreatitis

Yýlmaz Ünal, Aziz Mutlu Barlas
Department of General Surgery, Ankara Training and Research Hospital, Ankara-Turkey

BACKGROUND: Acute necrotizing pancreatitis (ANP) is the most severe form of acute pancreatitis (AP), and it has high mortality rates. Therefore, early diagnosis and treatment are of critical importance for the prognosis. The aim of this study was to investigate the effectiveness of immature granulocyte percentage (IG%) in the early prediction of ANP.
METHODS: This retrospective study included 96 adult patients hospitalized with a diagnosis of AP. Demographic data of the patients were recorded. The white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), IG%, C-reactive protein (CRP), and amylase levels were determined. Furthermore, computed abdominal tomography was applied to the patients, and the length of hospital stay was recorded. Patients were divided into two groups as those with acute edematous pancreatitis and ANP, according to the tomography results. The differences between the groups were analyzed statistically.
RESULTS: The WBC count, NLR, CRP, and IG% were significant markers in the prediction of ANP. However, IG% had higher values with regard to the sensitivity, specificity, AUROC, and negative and positive predictive values (100%, 95%, 0.982, 78.9%, and 100%, respectively).
CONCLUSION: An increased IG% is a simple, fast, and effective marker in the early prediction of ANP.

METHODS: This retrospective study was carried out on 96 adult patients who were hospitalized with a diagnosis of acute pancreatitis. Demographic data of the patients were recorded. White blood cell count, neutrophil/lymphocyte ratio, IG%, C-reactive protein and amylase levels were determined. Furthermore computed abdominal tomography was applied to the patients and the length of hospital stay was recorded. The patients were divided into two groups as acute edematous pancreatitis and acute necrotizing pancreatitis according to the tomography results. The differences between the groups were analyzed statistically.
RESULTS: White blood cell count, neutrophil/lymphocyte ratio, C-reactive protein and IG% were significant markers in the prediction of acute necrotizing pancreatitis. However, IG% had higher values of sensitivity, specificity, AUROC, negative and positive predictive values ( 100%, 95%, 0.982, 78.9%, 100%,respectively).
CONCLUSION: Increased IG% is a simple, fast, and effective marker in the early prediction of acute necrotizing pancreatitis.

Keywords: Acute necrotizing pancreatitis, early prediction; immature granulocyte percentage.

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Akut nekrotizan pankreatitin erken tahmininde artmýþ immatür granülosit yüzdesinin rolü

Yýlmaz Ünal, Aziz Mutlu Barlas
Ankara Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Ankara

AMAÇ: Akut nekrotizan pankreatit akut pankreatitin en þiddetli formudur ve yüksek mortalite oranlarýna sahiptir. Bu yüzden bu hastalýkta erken taný ve tedavi prognoz açýsýndan kritik önem taþýmaktadýr. Bu çalýþmanýn amacý immatür granülosit yüzdesinin (IG%), akut nekrotizan pankreatitin erken tahminindeki etkinliðini araþtýrmaktýr.
GEREÇ VE YÖNTEM: Bu geriye dönük çalýþma akut pankreatit tanýsýyla hastaneye yatýrýlan 96 eriþkin hasta üzerinde gerçekleþtirildi. Hastalarýn demografik verileri kaydedildi. Beyaz küre sayýsý, nötrofil/lenfosit oraný, IG%, C-reaktif protein ve amilaz düzeyleri tespit edildi. Ayrýca hastalara kontrastlý bilgisayarlý abdominal tomografi incelemesi yapýldý ve hastanede kalýþ süreleri kaydedildi. Hastalar tomografi sonuçlarýna göre akut ödematöz pankreatit ve akut nekrotizan pankreatit olarak iki gruba ayrýldý. Gruplar arasýndaki farklýlýklar istatistiksel olarak analiz edildi.
BULGULAR: Beyaz küre sayýsý, nötrofil/lenfosit oraný, C-rektif protein ve IG% akut nekrotizan pankreatit tahmininde anlamlý belirteçlerdi. Ancak IG%’nin duyarlýlýk, özgüllük, AUROC, negatif ve pozitif tahmin edici deðerleri diðerlerinden daha yüksek idi (sýrasýyla, %100, %95, 0.982, %78.9, %100).
TARTIÞMA: Artmýþ IG% akut nekrotizan pankreatitin erken tahmininde basit, hýzlý ve etkili bir belirteçtir.

Anahtar Kelimeler: Akut nekrotizan pankreatit, erken tahmin; immatür granülosit yüzdesi.

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