NGHIÊN CỨU NỒNG ĐỘ TNF-α HUYẾT THANH VÀ GIÁ TRỊ DỰ BÁO MỨC ĐỘ NẶNG Ở BỆNH NHÂN VIÊM TỤY CẤP TẠI BỆNH VIỆN ĐA KHOA TRUNG ƯƠNG CẦN THƠ NĂM 2025-2026

Abstract

Background: TNF-α participates in the early inflammatory response in acute pancreatitis; data on its predictive value and combined models in Can Tho remain limited. Objectives: To describe serum TNF-α and selected clinical and laboratory characteristics; develop severity prediction models combining TNF-α with APACHE II or BISAP; and assess treatment outcomes and the association with in-hospital mortality. Materials and methods: This prospective analytical observational study included 96 patients with acute pancreatitis at Can Tho Central General Hospital during 2025-2026. Serum TNF-α was measured by ELISA within 24 hours. Two logistic models combined TNF-α with APACHE II or BISAP; discrimination was assessed using ROC curves and AUCs. Results: Severe acute pancreatitis occurred in 31.2%. TNF-α was higher in severe than non-severe disease (8.59 [4.24-11.98] vs. 5.07 [4.01-6.29] pg/mL; p < 0.001). TNF-α alone had an AUC of 0.722. The TNF-α + APACHE II model had an AUC of 0.971 versus 0.961 for APACHE II alone; the TNF-α + BISAP model had an AUC of 0.907 versus 0.820 for BISAP alone. In-hospital mortality was 9.4%. TNF-α was higher among non-survivors than survivors (20.40 [10.63-25.22] vs. 5.19 [3.98-6.84] pg/mL; p < 0.001); the univariable OR was 1.269 per 1 pg/mL increase (95% CI: 1.113-1.447). Conclusion: Serum TNF-α was elevated in severe acute pancreatitis. The combined models had descriptively higher AUCs than their corresponding individual scores in this cohort, but direct statistical testing of AUC differences was not performed. Mortality findings are exploratory; external validation is required.