Abstract:Objective To investigate the predictive efficacy of six inflammatory combined indicators mainly derived from complete blood count，including neutrophil-lymphocyte ratio（NLR），systemic inflammatory response index（SIRI），systemic immune inflammation index（SII），inflammatory burden index（IBI），pan-immunoinflammatory value（PIV），and C-reactive protein to albumin ratio（CAR）, for early severity and complicated organ failure（OF）in acute biliary pancreatitis（ABP）. Methods The clinical data of 544 ABP patients admitted to the Northern Jiangsu People's Hospital from January 2017 to December 2020 were retrospectively analyzed. The patients were divided into MAP group（mild acute pancreatitis，n=274），and non-MAP group（moderately severe/severe acute pancreatitis，n=270）. Baseline data and laboratory indicators were collected and compared between groups. The receiver operating characteristics（ROC）curve was used to assess the predictive value of each inflammation indicator on the severity of early ABP and the occurrence of OF. Results Compared to the MAP group，non-MAP patients exhibited higher body weight，greater proportion of alcohol consumption history，longer hospital stays，and higher hospitalization costs，as well as higher levels of six inflammatory combined indicators（P＜0.05）. ROC curve analysis revealed that the areas under the curve（AUCs）of SII，PIV，SIRI，NLR，IBI，and CAR for predicting early moderately severe/severe ABP within 24 hours of admission were 0.635，0.632，0.624，0.616，0.592 and 0.582，with SII showing the highest AUC；among the six inflammatory combined indicators，procalcitonin and C-reactive protein，CAR had the largest AUC for predicting concurrent organ failure （AUC=0.772）. Conclusion ABP patients with higher body weight and more alcohol consumption were more likely to progress to moderately severe/severe ABP. SII and CAR showed superior predictive value for disease severity and the occurrence of OF，respectively，and may serve as early warning indicators for disease progression and clinical outcomes in ABP patients.