The Evaluation Value Of NLR In Severity And Systemic Complications Of Acute Pancreatitis

Aims: Acute pancreatitis is an inflammatory disease of the pancreas and a common critical disease of the digestive system.Early assessment of the severity and systemic complications of acute pancreatitis can improve the prognosis.The purpose of this study was to evaluate the value of NLR in the severity and systemic complications of acute pancreatitis.Methods: A total of 182 patients with acute pancreatitis were retrospectively enrolled.Collected the general information and related clinical data of the AP patients.Divided patients into mild,moderately severe and severe groups according to the revised Atlanta classification,and compared the statistical differences between groups in age,gender,etiology and laboratory indicators.According to the presence or absence of systemic complications,AP patients were divided into two groups,and the laboratory indicators such as NLR and NLR48 h were compared between the two groups for statistical differences.The receiver operating characteristic(ROC)curve was used to compare the effectiveness of NLR,NLR48 h,white blood cell counts and neutrophil counts in predicting the systemic complications and severity of acute pancreatitis.Results:(1)According to the revised Atlanta classification,NLR、NLR48h、white blood cell counts and neutrophil counts in the severe group was found to be statistically higher than the mild AP group.And lymphocyte counts in severe group is lower than moderate and mild group.(2)NLR,NLR48 h,white blood cell counts,and neutrophil counts in patients with systemic complications were higher than those without systemic complications(P <0.05).The lymphocyte counts in patients with systemic complications was lower than those without systemic complications(P <0.001).(3)The area under the ROC curve that used to assess the value of NLR in the prediction of severity according to the revised Atlanta classification is 0.863.When the NLR cut-off value was 7.81,sensitivity and specificity were 77.4% and 79.8%.The areas under the ROC curve of NLR48 h,white blood cell counts and neutrophil counts were 0.822,0.736 and 0.781.(4)The area under the ROC curve that used to assess the value of NLR in the prediction of systemic complicationss is 0.863.When the NLR cut-off value was 10.56,sensitivity and specificity were 85.7% and 76.2%.The areas under the ROC curve of NLR48 h,white blood cell counts and neutrophil counts were 0.797、0.674 and 0.717.Conclusions: Neutrophil to lymphocyte ratio is closely related to the severity and the systemic complications of AP.According to our data,we suggest using NLR> 7.81 and NLR> 10.56 as the effective value to predict the severity and the occurrence of systemic complications of acute pancreatitis.