The Relationship between Neutrophil-Lymphocyte Ratio and Clinal
Laboratory Data in Acute Pancreatitis

 

Tetiana Formanchuk¹, Hryhoriy Lapshyn², Mariya Pokidko¹, Andrii Formanchuk³,
Igor Vovchuk¹

 

¹Department of Surgery №2 with course of basic stomatology, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
²Department of Surgery, University Medical Center Luebeck, Germany
³Department of Surgery №1 with course of urology, National Pirogov Memorial Medical University, Vinnytsya, Ukraine

 

SUMMARY

 

Introduction: Neutrophil-lymphocyte ratio (NLR) is one of the laboratory biomarkers used in clinical practice to predict severity and mortality of acute pancreatitis (AP), however, there is currently insufficient information about the changes of NLR in the dynamics in relationship with other clinical and laboratory data.
Aims: To assess the relationship between NLR values and other demographics, clinical and simple laboratory data in patients with acute pancreatitis.
Methods: The data of two hundred twenty-nine patients with AP were analyzed. All patients were divided into two groups: the group with a positive outcome and the group with a fatal outcome. NLR was counted on the 1^st, 3^rd and 5^th day after admission in each group. The dynamics of NLR index by groups and days, as well as its correlation with other 18 simple laboratory parameters were evaluated.
Results: The level of NLR rate itself was significantly higher on the 1^st, 3^rd and 5^th day in the group with the fatal result compared with the group with the positive result (p < 0.05). In patients with AP with the positive result of treatment, there was a gradual decrease in the rate between the 1^st and the 3^rd day (-21.8%) (p < 0.05). The overall dynamics of the indicator between the 1^st and the 5^th day was -21.5%. In contrast to the group of patients with the fatal outcome, despite the infusion therapy, there was an increase in NLR rate between the 1^st and 3^rd day of +15.7%. The overall dynamics between the 1^st and 5^th day was -34.0%. A significant negative relationship of the Spearman's rank correlation coefficient between NLR on the 1^st and 3^rd day with the fatal outcome was revealed. The highest reliability of this indicator was found on the 3^rd day after admission (p < 0.0001). In the group of patients with a positive result, a correlation between NLR on the 1^st day and stabs on the 1^st day, segmental forms on the 1^st day, serum amylase on the 1^st day was found. A very high correlation was found with the level of lymphocytes on the 1^st day (rs = -0.98, p < 0001). In the group of patients with the fatal outcome, a statistically significant correlation (p < 0.05) of moderate strength was found between the value of NLR and the following indicators: glucose level on the 1^st day, total protein on the 5^th day, prothrombin index on the 5^th day. A high correlation was found with the level of segmental forms on the 1^st day (rs = 0.7) and a very high correlation with the level of lymphocytes on the 1^st day (rs = -0.99).
Conclusions: There was a significant increase in NLR on the 1^st, 3^rd, and 5^th day in the group of patients with AP with the fatal outcome compared with the group of patients with AP with the positive result. Elevated NLR levels on the 1^st and 3^rd day seem to be associated with hospital mortality in patients with AP. No correlation was found between NLR rate and clinical data in the group with fatal outcome. The main indicators among simple laboratory parameters for determining the predictors of lethal outcome in AP in different periods after hospitalization were: the level of blood glucose, lymphocytes, total protein, serum amylase, prothrombin index.

 Keywords: acute pancreatitis, markers, neutrophil-lymphocyte ratio, laboratory parameters

Corresponding author:

Tetiana Formanchuk

e-mail: mitykt@gmail.com