Use of band cell percentage as an early predictor of death and ICU admission in severe acute pancreatitis

Abstract

Background/aims: Severe acute pancreatitis has a high mortality rate, with over half of the deaths occurring from multiorgan failure in the first seven days of hospitalization. Recruitment of neutrophils to the inflammation in the pancreas is the early event that can escalate to the systemic inflammatory response that causes multiorgan failure. We undertook a retrospective chart review study to ask whether the percentage of immature neutrophils (band cells) in plasma could be used as an early predictor of adverse outcomes (ICU admissions and deaths).

Methodology: Age, gender, etiology, albumin, glucose, AST, ALT, y-glutamyltransferase, Ranson score, and band cell percentage were collected from the charts of 169 patients with documented severe acute pancreatitis. Odds, ratios and ROC curves for ICU admissions and deaths were obtained, and sensitivity and specificity for these outcomes was calculated.

Results: Two parameters, band cell percentage and Ranson score, were statistically associated with adverse effects. At their optimal cut-off values, calculated from the ROC curves, they did not differ significantly from each other in their sensitivity and specificity for predicting either death or ICU admission.

Conclusions: Band cell percentage might be used clinically as a simple early predictor of adverse outcome in severe acute pancreatitis.