Early identification of the severity of acute pancreatitis by platelet and coagulation markers / 中国医师杂志

ABSTRACT

Objective:To investigate whether platelet and coagulation-related indicators can be used as early indicators of severity of acute pancreatitis.Methods:A total of 142 patients with acute pancreatitis admitted to Beijing Friendship Hospital from 2017 to 2018 were included in this study. According to the Ranson score, they were divided into mild group and severe group. Severe pancreatitis was used as the outcome index. Univariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed on single indicators with statistically significant differences between mild and severe patients to determine the discriminative value of disease severity.Results:According to the Ranson score, 142 patients were divided into severe and mild groups, 43 patients with severe disease, and 99 patients with mild disease. There was a statistically significant difference in platelet, fibrinogen (FIB), and D-Dimer between the two groups on the first day of admission ( P<0.05). The area under ROC curve and 95% CI of platelets (PLT) , FIB and D-Dimer were 0.61 (0.52, 0.71), 0.70 (0.59, 0.80) and 0.72 (0.62, 0.82), respectively. Multivariate logistic regression models of PLT, FIB and D-Dimer were fitted, and ROC curve was analyzed. The area of ROC curve of PLT combined with D-Dimer was 0.74 (0.65, 0.83), and the area of ROC curve of FIB combined with D-Dimer was 0.75 (0.66, 0.85). Conclusions:Platelet, FIB and D-Dimer can be used as independent risk factors to judge the severity of pancreatitis. The early predicative value of FIB combined with D-Dimer on the severity of the disease is higher than that of the PLT combined with D-Dimer.