Abstract
It is important to identify the patients with high-risk progression to develop severe acute pancreatitis (SAP). The study was to assess whether neutrophil to lymphocyte ratio (NLR) and fluid sequestration (FS) could represent useful markers for predicting the severity. A total of 1639 patients who underwent clinical diagnosis of AP was performed. Various serologic and clinical parameters on admission were investigated. Chronologic change in NLR and FS were analyzed, and theirs utility for predicting severity of AP was evaluated by receiver operator characteristic (ROC) curve analysis. Correlation analysis was assessed by Spearman’s rank test. NLR and FS levels were both increased significantly in SAP and positively correlated with Ranson score and hospital stays. The ROC curve analyses showed the optimal cut-off values of NLR for admission with day0, day1, day2 were 9.64, 6.66 and 6.50, giving sensitivity of 77–82%. The optimal cut-off values of FS for admission with day1, day2, day3 were 1375 ml, 2345 ml and 3424 ml, giving sensitivity of 62–75%. Moreover, measurement of NLR and FS together exhibited a similar area under curve (AUC) and sensitivity for SAP prediction compared with the those of Ranson score. Increase of NLR and FS are correlated with severity and can be suggested as a predictive factor in an early stage of AP.
Highlights
Despite advances of diagnosis and treatment, acute pancreatitis (AP) was still the largest contributor to aggregate costs and the fifth leading cause of in-hospital deaths[1]
A series of scoring systems are currently accepted to stratify the severity of AP and the initiation of aggressive early treatment. the Ranson criteria, the Acute Physiology and Chronic Health Evaluation (APACHEII) system and the Bedside Index for Severity in Acute Pancreatitis (BISAP) score are most widely used in clinical practice
Most patients predominately presented with a disease of abdominal pain (59.8%) and the risk factors of AP were presumed to be alcohol in 114 patients, smoking in 86 patients, gallstone in 56 patients, prior acute pancreatitis in 40 patients and others in 32 patients
Summary
Despite advances of diagnosis and treatment, acute pancreatitis (AP) was still the largest contributor to aggregate costs and the fifth leading cause of in-hospital deaths[1]. The mean values of NLR levels in patients with SAP on admission within day[0], day[1], and day[2] were 18.92 ± 15.50, 14.09 ± 9.92, 11.04 ± 8.06, respectively; which were significantly higher than those in the MAP groups (Fig. 1A, P < 0.001).
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