ABSTRACT
Introduction: Acute pancreatitis is a common inflammatory condition with potentially severe progression. Several prognostic systems (Ranson’s criteria, Glasgow score, APACHE II, BISAP) are available to assess severity; however, they are complex, require multiple data points, and are of limited utility in emergency settings. This study investigated inflammatory and metabolic syndrome components at admission as predictors of acute pancreatitis severity. Materials and Methods: We retrospectively analyzed 103 patients admitted with acute pancreatitis to the Gastroenterology Department of Mureș County Emergency Hospital. Patients were classified as mild, moderate, or severe according to the Revised Atlanta Classification. Demographic data, laboratory findings, and metabolic syndrome components were compared across groups. Results: The mean patient age was 56 years, and most were male. Disease severity was moderate in 36%, severe in 24%, and mild in 40% of cases. Elevated neutrophil-to-lymphocyte ratio (NLR), CRP, hypoalbuminemia, and admission glucose levels were independent, dose-dependent risk factors for severity (p < 0.05). The optimal baseline NLR cut-off for severe acute pancreatitis was ≥10.5 (sensitivity 87.5%, specificity 78.9%; p = 0.001). Hypertension was also significantly associated with increased severity (p = 0.016). Necrosis was strongly associated with severe cases (p = 0.0001). Hospital stay increased with severity (p = 0.005). Conclusion: At admission, hypertension as a component of metabolic syndrome, elevated glucose, hypoalbuminemia, elevated NLR (≥10.5), and increased CRP are independent and dose-dependent risk factors for severe acute pancreatitis. These readily available markers may improve early risk stratification in emergency settings.