• Ying Huang, Jie Xiao, Tao Cai, Li Yang, Fengxia Shi, Yupeng Wang, Yun Li, Ting Shi, Cunyan Li, Ya Peng, Jie Chen, Yali Song, Jiliang Hu, and Chaochao Tan.
• Department of Emergency, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China.
• J Crit Care. 2019 Apr 1; 50: 303-308.

PurposeTo investigate the relationship between immature granulocyte percentage (IG%) and acute respiratory distress syndrome (ARDS) in patients with acute pancreatitis (AP).Materials And MethodsA cohort of 2289 patients with AP was screened; 1933 were enrolled in this prospective multicenter study. Blood samples for IG% analysis were collected on admission and processed using a hematology analyzer. Demographic, radiological, and clinical laboratory data were prospectively collected and reviewed retrospectively.ResultsIncreased IG% reflected significant upward tendency of ARDS incidence and severity. Multivariable logistic regression revealed that Acute Physiology and Chronic Health Evaluation (APACHE) II, CT severity index, C-reactive protein, white blood cells, granulocytes, lymphocytes, and IG% (OR 1.297 [95% CI 1.230-1.368]) were independent factors predicting ARDS onset in patients with AP. Receiver operating characteristic curve analysis revealed that area under the curve for APACHE II and IG% were 0.837 (95% CI 0.798-0.876) and 0.821 (95% CI 0.794-0.849), respectively. The combination of APACHE II score and IG% demonstrated excellent predictive power for ARDS incidence.ConclusionsIG% is a new type of biomarker for ARDS in patients with AP, which may promote timely and efficient identification of individuals at high risk for ARDS in the early stages of disease.Copyright © 2018 Elsevier Inc. All rights reserved.

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