Clinical Significance Of The Neutrophil-lymphocyte Ratio As An Early Predictive Marker In Patients With Severe Acute Pancreatitis

Objective:To explore the sensitivity and specificity of neutrophil-lymphocyte ratio as an early predictor of severe acute pancreatitis Methods:This retrospective study included patients diagnosed with acute pancreatitis in our hospital from January 2017 to May 2020.According to the revised Atlanta Classification of Acute Pancreatitis,94 patients were assigned to mild acute pancreatitis(MAP),moderate severe acute pancreatitis(MASP),and severe acute pancreatitis(SAP).Clinical characteristics and early laboratory blood test parameters were used as independent variables.Chi-square test and t test were used to analyze the independent variables to determine whether the difference between the two groups was statistically significant.Logistic regression analysis and observer operating characteristic curve analysis were performed to evaluate the predicted values of significant difference variables.Results:Among the 94 patients,65 cases(69.1%)were in mild and moderate severe group,and 29 cases(30.9%)were in severe group.Tachycardia,fever,white blood cell count(WBC),neutrophil-lymphocyte ratio(NLR),D-dimer,lactate dehydrogenase(LDH),C-reactive protein(CRP),procalcitonin(PCT),triglyceride,blood glucose and total bilirubin were significantly increased,while serum calcium was significantly decreased in severe group.NLR(adjusted odds ratio [AOR]: 1.379;95% confidence interval [CI]: 1.120-1.698),D-dimer(AOR: 1.493;95%CI: 1.038-2.148),CRP(AOR: 1.014;95% CI:1.000-1.027),serum calcium(AOR: 0.040;95%CI: 0.003-0.469)was significant in logistic regression analysis.The sensitivity(86.0%)and specificity(72%)of NLR were higher,and the area under the curve was the highest(0.814).Conclusions:The increase in NLR was associated with severe acute pancreatitis.NLR is expected to be a predictor of early severity of acute pancreatitis in the emergency department.