Abstract:

Objective To investigate the value of neutrophil-lymphocyte ratio (NLR) for predicting the severity of acute pancreatitis (AP) based on the Revised Atlanta Classification. Methods The clinical data of 118 patients with AP were retrospectively analyzed. Based on the Revised Atlanta Classification, the patients were assigned to 3 groups, i.e. the mild acute pancreatitis group, moderately severe acute pancreatitis group, and severe acute pancreatitis group. The dynamic changes in blood NLR levels in each group 1 and 7 d after admission and at discharge were observed, as well as differences across groups at each time points. The correlations between NLR and acute physiology, chronic health evaluation (APACHE) II score, length of ICU stay, and length of hospital stay were analyzed. The receiver operating characteristic curves (ROC curves) were plotted to compare the efficiency of NLR, BUN, APACHEII score, and NLR combined with BUN for predicting the severity of acute pancreatitis. Results The NLR in the severe acute pancreatitis group was the highest 1 and 7 d after admission, followed by the moderately acute pancreatitis group and the mild acute pancreatitis group (P=0.000). The correlations between NLR and APACHEII score，length of ICU stay, and length of hospital stay were positive (r=0.577，P=0.000；r=0.527，P=0.000；r=0.597，P=0.000, respectively). There was no statistical difference between the area under curve (AUC) of NLR and APACHEII score for predicting moderately-severe acute pancreatitis, but they were superior to BUN (0.876±0.032 vs 0.873±0.031, P=0.944; 0.876±0.032 vs 0.660±0.050, P=0.000). There were no statistical differences between NLR and APACHEII score, and NLR and BUN for predicting severe acute pancreatitis (0.794±0.053  vs  0.892±0.033, P=0.118; 0.794±0.053  vs  0.745±0.064, P=0.560). The combination of NLR and BUN could increase the area under curve and the diagnostic specificity. Conclusion NLR has certain clinical significance for predicting the severity of acute pancreatitis.

Key words: acute pancreatitis , neutrophil-lymphocyte ratio , severity , prediction