Early Prediction of Acute Gastrointestinal Injury in Patients with Acute Pancreatitis by C-reactive Protein/Albumin Ratio Combined with IL-23.

Objective: To explore the effect of C-reactive protein/albumin ratio (CAR) combined with IL-23 on early prediction of acute gastrointestinal injury (AGI) in patients with acute pancreatitis (AP).

Methods: The clinical data of 120 AP patients were retrospectively analyzed, of which 103 patients were in the non-severe AP group and 20 were in the severe AP group (SAP group). The medical records and clinical indicators of all the patients were collected and statistically analyzed.

Results: At admission, there was no statistically significant difference in temperature, respiratory rate, alanine aminotransferase, aspartate aminotransferase, LPS, and total bilirubin, and there was a statistically significant difference in heart rate, IL-23, procalcitonin, blood creatinine, CRP, blood urea nitrogen, serum albumin, blood glucose, and CAR. Multifactorial logistic regression analysis revealed that CAR and IL-23 were significant predictors of SAP. CAR and IL-23 at admission were positively correlated with BISAP score (r=0.301, P<0.001; r=0.295, P<0.01). ROC curves showed that the area under the curve of CAR was 0.732 (95% CI: 0.770-0.901), with a sensitivity of 75.00% and a specificity of 85.9%, respectively, and the area under the curve of IL-23 was 0.848 (95% CI: 0.731-0.887), with a sensitivity of 80% and a specificity of 71.4%, respectively. The area under the curve of CAR and IL-23 was 0.899 (95% CI: 0.846-0.936), with a sensitivity of 78% and a specificity of 86.2%.

Conclusion: CAR and IL-23 have significant advantages in predicting the severity of AGI in patients with AP, and their predictive efficacy is further increased especially when they are combined.