Which factor is associated with increased morbidity in severe pancreatitis upon admission?

The association of increased morbidity in severe pancreatitis upon admission with a white blood cell count greater than 16,000 is well established. Elevated white blood cell counts can indicate a systemic inflammatory response or infection, both of which can complicate the course of pancreatitis and are markers of more severe disease. In the context of acute pancreatitis, a high white blood cell count is often present because the body is responding to inflammation and possible infection within the pancreas or surrounding tissues. As disease severity increases, the patient's overall prognosis may worsen, leading to higher rates of complications and morbidity.

Other factors, such as LDH levels, age, and alkaline phosphatase (ALP) levels, also provide important information but are less definitive indicators of immediate morbidity upon admission in this specific context. For example, while LDH levels may indicate tissue damage, and higher ALP levels might suggest biliary involvement, they do not consistently correlate with morbidity as strongly as leukocytosis does. Age less than 45 typically indicates a better prognosis, as younger patients often tolerate the condition better. Thus, white blood cell count emerges as a critical factor for assessing the initial severity and potential outcomes in patients with acute pancreatitis.