Abstract

Acute cholecystitis (AC) is a common surgical emergency, usually developing secondary to gallstones and characterized by gallbladder inflammation. Although classical biomarkers such as leukocyte count and C-reactive protein (CRP) are widely used for diagnostic purposes, composite inflammation-based indices such as Hemoglobin, albümin, lenfosit ve trombosit (HALP), Systemic immune-inflammation index (SII), and Systemic Inflammatory Response Index (SIRI) have recently emerged as important prognostic markers. This study aims to evaluate the association of HALP, SII, and SIRI scores with clinical outcomes [hospital length of stay, Internal care unit (ICU) requirement, and gallstone presence] in adults hospitalized with acute cholecystitis. A total of 88 patients hospitalized with acute cholecystitis between January 2020 and December 2024 were included. Demographic data, admission laboratory parameters, and HALP, SII, and SIRI scores were retrospectively analyzed. Correlation tests and Receiver Operating Characteristic (ROC) analysis were performed to assess prognostic performance. No statistically significant association was observed between HALP, SII, and SIRI scores and either length of hospital stay or intensive care unit requirement (p>0.05). In contrast, WBC levels showed a positive correlation with both parameters and were significantly higher in patients requiring intensive care (p=0.035). In ROC analysis, the Area Under the Curve (AUC) value for Leukocyte (WBC) was determined as 0.859. The significant increase in CRP and glucose levels in patients with acute cholecystitis acalculus suggests that this variant is associated with a more pronounced inflammatory process. In this study, traditional biomarkers especially WBC were more predictive of prognosis in acute cholecystitis than composite inflammation scores. Further time-series, prospective, and multicenter studies are warranted to validate the clinical utility of indices such as HALP, SII, and SIRI.

Key words: Acute cholecystitis, Hemoglobin, albümin, lenfosit ve trombosit score, systemic immune-inflammation index, prognostic markers, mortality