A novel Neutrophil-C-Reactive Protein Index (NCI) can enhance risk stratification for severe acute pancreatitis and in-hospital mortality, crucial in resource-limited settings.

• Optimal NCI cut-off values are ≥1877 for severe pancreatitis and ≥3180 for mortality.
• NCI predictions for severe pancreatitis had AUCs of 0.853 to 0.897 across different patient cohorts, outperforming other biomarkers.

This tool leverages common blood tests for timely and informed decision-making in surgical intervention.

• For mortality, NCI AUCs ranged from 0.824 to 0.902, showing strong calibration and relevant post-test probabilities.