The AST to platelet ratio index is a predictor of pleural effusion development in acute pancreatitis

Abstract

Pleural effusion is a common extra pancreatic complication of acute
pancreatitis and is associated with a more severe clinical course and
poorer outcomes. Early identification of patients at risk remains
clinically important. The aim of this study was to evaluate the predictive
value of non-invasive liver fibrosis indices for the development of
pleural effusion in patients with acute pancreatitis. This retrospective
single-centre observational study included 97 patients hospitalised
with acute pancreatitis. Laboratory parameters obtained at admission
were used to calculate several liver fibrosis indices, including APRI,
AARPRI, FIB-4, ALBI, ABAI, GPR, APP, and FIS. The presence of
pleural effusion was assessed using chest radiography. Comparative
analysis demonstrated that ABAI, AARPRI, ALBI, APRI, FIS, and
FIB-4 were significantly associated with pleural effusion. Receiver
operating characteristic analysis showed the highest discriminative
ability for ALBI (AUC 0.707), followed by ABAI (AUC 0.695) and
APRI (AUC 0.650). In univariate logistic regression, ALBI, FIS,
and APRI were significant predictors of pleural effusion, whereas in
multivariate analysis only APRI remained an independent predictor
(OR 3.677, p=0.047). These findings indicate that non-invasive liver
fibrosis indices, particularly APRI, may serve as simple and accessible
biomarkers for early prediction of pleural effusion in patients with
acute pancreatitis.