Value Of The Neutrophil-lymphocyte Ratio To Predict Poor Prognosis In Patients With Acute Pancreatitis

Objective: This study intends to explore the neutrophil-lymphocyte ratio(NLR)to predict the prognostic value in patients with acute pancreatitis,to study the effectiveness of NLR in the early prediction of the severity of acute pancreatitis and organ failure,and determine the best cutoff for predicting a poor prognosis in patients with acute pancreatitis value.Methods:Methods the clinical data of 420 patients who were diagnosed as acute pancreatitis in the First Affiliated Hospital of Dalian Municipal Central Hospital Affiliated to Dalian Medical University from January 2015 to December 2017 were retrospectively analyzed.They were divided into 2 groups.In the first group,the patients were divided into mild and severe groups according to the severity of acute pancreatitis.Mild group: group MAP: not associated with organ failure and local or systemic complications of acute pancreatitis;severe group: there is a transient(less than 48 hours)or continuous(over 48 hours)of organ failure and(or)local or systemic complications of acute pancreatitis patients.There were 360 patients in the mild disease group and 60 patients in the severe group.By comparing and analyzing the NLR values of two groups of patients at admission,24 hours and 48 hours after admission,the best cut-off value of NLR in predicting the severity of acute pancreatitis was identified.NLR0 represents the NLR value obtained by the blood testcalculation at admission to the hospital;NLR1 and NLR2 represent the NLR value obtained by the blood test of 24 h and 48 h morning after admission,respectively.The second time group was divided into organ failure group and non organ failure group according to whether there was organ failure.There were 27 patients in organ failure group and 393 patients in organ failure group.The values of NLR0,NLR1 and NLR2 in the two groups were analyzed and compared,and the best cut-off value for early prediction of organ failure in acute pancreatitis was determined by NLR.The values of NLR0,NLR1 and NLR2 in the two groups were analyzed and compared,and the best cut-off value for early prediction of organ failure in acute pancreatitis was determined by NLR.Results:All of patients through the same conservative treatment,The median values of NLR0,NLR1 and NLR2 in severe group were 6.98,6.96 and 6.29,respectively.The median values of NLR0,NLR1 and NLR2 in mild group were 5,4.72 and 4.35,respectively,and NLR in severe group was significantly higher than that in mild group.P<0.05,the difference was statistically significant.The median values of NLR0,NLR1 and NLR2 in organ failure group were 7.82,7.08 and 6.35,respectively,and the median values of NLR0,NLR1 and NLR2 were 5.19,4.87 and4.48 respectively in patients without organ failure.P<0.05,there are significant differences.Through statistical analysis,the best cut-off value of NLR for predicting the severity of acute pancreatitis in early stage is 5.23,and the best cut-off value of NLR in predicting early organ failure in acute pancreatitis is 6.61.Conclusion : Neutrophil-lymphocyte ratio is a reliable predictor of poor prognosis in patients with acute pancreatitis,it is recommended that you choose the optimal cut-off value of 5.23 NLR on admission as a simple index prediction inpatients with acute pancreatitis severity,selected admission NLR optimal cut-off value of 6.61 as the prediction index simple organ failure in patients with acute pancreatitis.