NEUTROPHIL-LYMPHOCYTE RATIO AS AN EARLY PROGNOSTIC PREDICTOR OF THE COURSE OF ACUTE PANCREATITIS

Abstract

Summury. Introduction. One of the laboratory markers that can be used both to determine the severity of the systemic inflammatory response and to predict the further course of acute pancreatitis (AP) is the neutrophil-lymphocyte ratio (NLR).
 The aim of our work was to study the dynamics of changes in the NLR indicator on 1, 3 and 5 days after hospitalization in groups of patients with AP.
 Materials and methods: The data of 99 patients with AP of moderate severity and severe who were treated in the department of surgery and intensive care unit of the Vinnytsia city clinical emergency hospital for the period from January 2018 to December 2020 were analyzed. The diagnosis of AP was made based on the criteria of Atlanta, 2012. All patients were divided into two groups. The group of patients who survived consisted of 78 patients and 21 patients who died, respectively. NLR was calculated on the 1st, 3rd and 5th day after hospitalization of patients in a hospital in each group and the reliability of the difference of this indicator was evaluated. Results and discussion: The NLR on the day of hospitalization in the group of the dead did not differ significantly from the group of survivors and was (11,6±2,7) and (10,6±2,1), respectively (p>0,05). On the third day of hospital stay, despite infusion therapy, there was a significant increase in the NLR index in the group of the deceased to (13,8±4,6) and its decrease in the group of patients who survived to (6,8±2,3) (p<0,0001). On the fifth day of hospital stay, there was a decrease in the level of NLR in the group of the dead to (7,7±1,5), with a significant difference compared to the group of patients who survived — (7,0±1,7) (p<0,05). Conclusions: In this study, we did not find a significant difference in the NLR index on the 1st day of hospitalization in the groups of deceased patients with AP and surviving patients (p>0,05), however, we observed a sharp, significant increase in the NLR index on the 3rd day in the group of patients, who died compared to the group that survived (p<0,0001). On the 5th day after the hospitalization of the patients, against the background of the infusion therapy, a decrease in the NLR index was noted in both groups of patients to almost the same level, while maintaining a reliable difference between them (p<0,05).