【Abstract】Objective To evaluate the nutritional status in elderly patients with acute pancreatitis (AP) and analyze its relationship with immune function and prognosis. Methods A total of 122 elderly AP patients admitted in Department of Hepatobiliary and Pancreatic Surgery of our hospital from July 2021 to December 2023 were recruited, and divided into mild, moderate and severe groups according to the severity of AP (51,39 and 32 cases, respectively). The nutritional status [albumin (ALB) and transferrin (TRF) levels, geriatric nutritional risk index (GNRI)] and immune function (CD4+ and CD8+, and CD4+/CD8+) were compared among the three groups. Based on their clinical outcomes within 28 d after admission, they were assigned into survival group (110 cases) and death group (12 cases). SPSS statistics 24.0 software was used to process and analyze the data. Pearson correlation coefficient analysis was employed for correlation analysis, and receiver operating characteristic (ROC) curve was adopted to assess the predictive value of nutritional status and immune function indicators on death of elderly AP patients. Results There were statistical differences in ALB, GNRI, TRF, CD4+ and CD4+/CD8+ at admission among elderly patients with different severities of AP (P<0.05), and the above indicators were significantly lower in the severe group than the mild group and moderate group (P<0.05), and in the moderate group than the mild group (P<0.05). Pearson correlation coefficient analysis showed that ALB, GNRI and TRF were positively correlated with CD4+ and CD4+/CD8+ in elderly AP patients (P<0.05). At admission, the ALB, GNRI, TRF, CD4+ and CD4+/CD8+ in death group were significantly lower than those in survival group, and the differences were statistically significant (P<0.05 for all). ROC curve revealed that AUC value of ALB, GNRI, TRF, CD4+ and CD4+/CD8+ at admission in predicting death of elderly AP patients was 0.843 (95%CI 0.717-0.969, P<0.05), 0.741 (95%CI 0.597-0.884, P<0.05), 0.732 (95%CI 0.594-0.870, P<0.05), 0.796 (95%CI 0.669-0.923, P<0.05), and 0.911 (95%CI 0.848-0.974, P<0.05); optimum cut-off value was 31.97g/L, 88.25、2.08g/L, 36.37% and 1.59, respectively. The value was as high as 0.947 (95%CI 0.906-0.998, P<0.05) when the above five indicators combined together. Conclusion Malnutrition and immunosuppression promote the disease progression in elderly AP patients, and the nutritional status is closely associated with their immune function. Detecting ALB, GNRI, TRF, CD4+ and CD4+/CD8+ at admission is of significance in prediction of death in the patients.
