Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can predict the severity of gallstone pancreatitis

Seung Kook Cho,Saehyun Jung,Kyong Joo Lee,Jae Woo Kim

doi:10.1186/s12876-018-0748-4

Seung Kook Cho, Saehyun Jung + Show 2 more

Open Access

https://doi.org/10.1186/s12876-018-0748-4

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Journal: BMC gastroenterology	Publication Date: Jan 25, 2018
Citations: 50	License type: open-access

Affiliation: Yonsei University

Abstract

BackgroundNeutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) predict severity in various diseases. In this study, we evaluated the value of NLR and PLR as prognostic factors in acute pancreatitis (AP).MethodsPatients with AP were prospectively enrolled from March 2014 to September 2016 at Yonsei University Wonju College of Medicine. NLR and PLR were obtained at admission and were compared with other known prognostic scoring systems.ResultsA total of 243 patients were enrolled with an etiology of gallstone (n = 134) or alcohol (n = 109). NLR (17.7 ± 18.3 vs. 8.8 ± 8.4, P < 0.001) and PLR (344.1 ± 282.6 vs. 177.8 ± 150.1, P < 0.001) were significantly higher in the gallstone AP group than in the alcoholic AP group. For gallstone AP, NLR and PLR were significantly higher in severe AP, whereas high NLR and PLR were not related to severe AP in alcoholic AP. For the gallstone AP group, NLR and PLR demonstrated a predictive value significantly superior to C-reactive protein (CRP), whereas NLR, PLR, and CRP were not significant predictors for alcoholic AP.ConclusionOur study demonstrated that NLR and PLR can predict the severity of AP, but only in gallstone AP.

Highlights

Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) predict severity in various diseases
Mean age was higher in the gallstone acute pancreatitis (AP) group, whereas the male-to-female ratio and proportion of smokers were lower
Hypertension and liver cirrhosis were more frequent in patients with alcoholic AP than in Overall (N = 243)

Summary

Introduction

Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) predict severity in various diseases. The Ranson score, the Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) score, the Bedside Index for Severity in Acute Pancreatitis (BISAP) score, and the Glasgow-Imrie criteria are currently in wide use. These systems are time-consuming and difficult to apply to patients outside of intensive care settings because they use many variables [5]. They are unsuitable for the evaluation of patients at the time of admission or shortly thereafter. Simplified serum markers such as C-reactive protein (CRP), procalcitonin, interleukin-6, and interleukin-8 have been applied to predict the prognosis or severity of AP, but they are expensive, not readily available, and cannot adequately predict the prognosis or severity of AP [6]

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