Relationship between the C-reactive protein-albumin-lymphocyte ratio and disease outcome in patients with severe acute pancreatitis

Fan Yaping; Xing Binyu; Shen Cunyi; Ao Wen; Zhang Yazhuo; Yin Dan; Ning Feisha; Zhang Yanxiao

doi:10.11986/j.issn.1673-873X.2025.10.09

Abstract：Objective To investigate the relationship between the C-reactive protein-albumin-lymphocyte ratio(CALLY index)and disease outcome in patients with severe acute pancreatitis(SAP).Methods A convenience sample of 186 SAP patients ad-mitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2022 to December 2024 was included.Accord-ing to clinical outcome at 4 weeks after treatment,patients were allocated to an improvement group(n=126)and a deteriora-tion group(n=60).Collected data included age,body mass index(BMI),sex,etiology,presence of pleural effusion,Acute Physiology and Chronic Health Evaluation II(APACHE II)score and modified CT severity index(MCTSI)score on admis-sion,blood routine and biochemical indices,comorbidities,and levels of C-reactive protein(CRP),albumin(ALB)and lym-phocyte count(LYM).The CALLY index on admission was compared between the two groups.Receiver operating character-istic(ROC)curve analysis was used to assess the performance of the CALLY index in predicting disease outcome in SAP pa-tients,and multivariate logistic regression analysis was used to analyze factors influencing disease outcome.Results The CALLY index in the deterioration group was 0.25±0.04,lower than that in the improvement group(0.49±0.07),and the difference was statistically significant(t=24.686,P<0.001).ROC curve analysis showed that the admission CALLY index predicted disease outcome in SAP patients with an area under the curve(AUC)of 0.933(95%CI:0.888-0.983,P<0.001);the optimal cut-off value was 0.43,with a sensitivity and specificity of 85.73%and 86.40%,respectively.No signifi-cant differences were observed between the deterioration and improvement groups in age,BMI,sex,etiology,platelet count,aspartate aminotransferase,alanine aminotransferase levels,or proportions with comorbid diabetes,hypertension,or hypox-emia(P>0.05).The deterioration group had a higher proportion with pleural effusion,and higher APACHE Ⅱ and MCTSI scores on admission,white blood cell count,serum creatinine,and blood urea nitrogen than the improvement group,with sta-tistically significant differences(P<0.05).Multivariate analysis showed that APACHE Ⅱ score on admission(OR=2.314,95%CI:1.339-3.998),MCTSI score on admission(OR=2.168,95%CI:1.186-3.966),and CALLY index(OR=3.206,95%CI:1.877-5.474)were independent factors influencing disease outcome in SAP patients(P<0.05).Conclusion CCALLY index decline is closely correlated with poor disease outcome in SAP patients and may serve as an effective predictor of disease outcome and early prognosis in SAP.