To analyze the value of lactic acid, the ratio of lactate dehydrogenase to albumin (LAR), visceral fat index (VAI) and systemic immune inflammatory index (SII) in evaluating the condition and prognosis of elderly patients with acute pancreatitis (AP).

A total of 215 elderly AP patients admitted to Zhangjiagang First People's Hospital from January 2020 to January 2024 were divided into mild, moderate and severe AP groups according to their illness. According to the prognosis of patients, they were divided into survival and death groups. The differences of blood lactic acid, LAR, VAI and SII in patients with different conditions and different prognosis were compared, and the area under the curve (AUC) and efficacy of each index in evaluating the conditions and prognosis of elderly AP patients were evaluated by receiver operating characteristic (ROC) curve.

Among 215 patients, there were 99 patients with mild, 53 patients with moderate and 63 patients with severe AP; 24 cases died and 191 cases survived. With the progress of the patient's condition, the blood lactic acid, LAR, VAI and SII gradually increased, and there were statistically significant differences between groups (P<0.05). The blood lactic acid, LAR, VAI and SII in the dead group were significantly higher than those in the surviving group, and there were statistically significant differences between the two groups (P<0.05). Logistic multivariate regression analysis showed that the increase of blood lactic acid, LAR, VAI and SII were independent risk factors for the progress of the elderly AP patients, and also for their death (P<0.05). The ROC curve showed that the AUC of blood lactic acid, LAR, VAI and SII combined in evaluating the condition (severity) of elderly AP patients was 0.912, and the sensitivity and specificity were 85.35% and 89.04% respectively. The AUC of joint prediction of the prognosis (death) of elderly AP patients was 0.842, and the sensitivity and specificity were 81.99% and 86.28% respectively.

The combination of lactic acid, LAR, VAI and SII can guide the comprehensive evaluation of the condition and prognosis of elderly AP patients from multiple dimensions, such as self-organization injury, abnormal glucose and lipid metabolism and inflammatory reaction, and its evaluation and prediction efficiency are worthy of recognition.