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Pancreatology. 2017 Nov - Dec;17(6):893-897. doi: 10.1016/j.pan.2017.10.001. Epub 2017 Oct 6.

Evaluation of the prognostic value of neutrophil to lymphocyte ratio in patients with hypertriglyceridemia-induced acute pancreatitis.

Author information

1
Department of Internal Medicine, John H Stroger Hospital of Cook County, Chicago, IL, United States. Electronic address: ywang4@cookcountyhhs.org.
2
Department of Internal Medicine, John H Stroger Hospital of Cook County, Chicago, IL, United States.
3
Department of Gastroenterology, Rush University Medical Center, Chicago, IL, United States; Division of Gastroenterology and Hepatology, John H Stroger Hospital of Cook County, Chicago, IL, United States.
4
Division of Gastroenterology and Hepatology, John H Stroger Hospital of Cook County, Chicago, IL, United States.

Abstract

INTRODUCTION:

Recent studies attribute promising prognostic values to various inflammatory biomarkers in acute pancreatitis, including the following: the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and red cell distribution width (RDW). We aimed to determine the performance of these biomarkers for detecting disease severity in patients with hypertriglyceridemia-induced acute pancreatitis (HTG-AP).

METHODS:

We retrospectively reviewed 110 patients with HTG-AP and compared the NLR, PLR, and RDW in different severity groups. We performed receiver-operating characteristic (ROC) analysis to identify the optimal cut-off value for NLR to predict severe AP.

RESULTS:

NLR was significantly higher in patients with severe AP than mild and moderately severe AP (14.6 vs. 6.9, p < 0.001), and higher with organ failure upon presentation (9.1 vs. 7.1, p = 0.026). After dichotomization by the optimal cut-off value of 10 as determined by the ROC curve, the high-NLR group had a significantly longer length of stay (9.1 vs. 6.6 days, p = 0.001), duration of nil per os (4.9 vs. 3.7 days, p = 0.007), and higher rates of complications, including systemic inflammatory response syndrome (81.5% vs. 44.6%, p = 0.001) and persistent acute kidney injury (25.9% vs. 3.6%, p < 0.001). High NLR independently predicted severe acute pancreatitis in multivariate analysis (Odds ratio 6.71, p = 0.019).

CONCLUSION:

NLR represents an inexpensive, readily available test with a promising value to predict disease severity in HTG-AP. Among the three inflammatory biomarkers, NLR has the highest discriminatory capacity for severe HTG-AP, with an optimal cut-off value of 10.

KEYWORDS:

Acute pancreatitis; Hypertriglyceridemia; Neutrophil lymphocyte ratio

PMID:
29030078
DOI:
10.1016/j.pan.2017.10.001
[Indexed for MEDLINE]

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