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Vol. 11, No. 4, 2011
Issue release date: October 2011
Section title: Original Paper
Pancreatology 2011;11:445–452
(DOI:10.1159/000331494)

Neutrophil-Lymphocyte Ratio as a Predictor of Adverse Outcomes of Acute Pancreatitis

Azab B. · Jaglall N. · Atallah J.P. · Lamet A. · Raja-Surya V. · Farah B. · Lesser M. · Widmann W.D.
Departments of aInternal Medicine and bSurgery, Staten Island University Hospital, Staten Island, N.Y., cFeinstein Institute for Medical Research and Hofstra School of Medicine, Manhasset, N.Y., and dState University of New York Downstate Medical Center, Brooklyn, N.Y., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 12/29/2010
Accepted: 8/4/2011
Published online: 9/28/2011

Number of Print Pages: 8
Number of Figures: 4
Number of Tables: 3

ISSN: 1424-3903 (Print)
eISSN: 1424-3911 (Online)

For additional information: http://www.karger.com/PAN

Abstract

Background: Most acute pancreatitis risk scoring systems use total white blood cell counts (WBC) as one of the risk factors. The value of the neutrophil-lymphocyte ratio (NLR) to predict the severity of acute pancreatitis has not been previously evaluated. Methods:This observational study included 283 patients admitted to a tertiary center between 2004 and 2007. The patients were arranged into tertiles according to NLR and WBC values. The primary outcomes were intensive care unit (ICU) admission and length of stay (LOS) in the hospital. Results: According to NLR tertiles, patients in the 3rd tertile (NLR ≧7.6) had significantly more ICU admissions (17 vs. 2.2%, p < 0.0001) and longer average LOS (6.2 vs. 4.2 days, p < 0.002) compared with those in the 1st tertile (NLR <3.6). According to WBC tertiles, patients in the 3rd tertile had more ICU admissions (12.6 vs. 6.2%, p = 0.12) and a longer average LOS (5.8 vs. 4.4 days, p = 0.059) compared to patients in the 1st WBC tertile, but this did not reach statistical significance. In the multivariate model including NLR, WBC and other predictors, only NLR tertiles (p < 0.0262) and modified early warning scores (p < 0.0025) were significant predictors of ICU admission. Likewise, in the multivariate model of LOS, only NLR and glucose level were significant predictors of longer LOS (p < 0.0161 and p < 0.0053, respectively). Conclusion: NLR is superior to total WBC in predicting adverse outcomes of acute pancreatitis. According to our data, we suggest using the NLR cutoff value of >4.7 as a simple indicator of severity in patients presenting with acute pancreatitis.


  

Author Contacts

Basem Azab, MD
Department of Internal Medicine
Staten Island University Hospital, 475 Seaview Avenue
Staten Island, NY 10305 (USA)
Tel. +1 347 607 8727, E-Mail basemnady2000@yahoo.com

  

Article Information

Received: December 29, 2010
Accepted after revision: August 4, 2011
Published online: September 28, 2011
Number of Print Pages : 8
Number of Figures : 4, Number of Tables : 3, Number of References : 37

  

Publication Details

Pancreatology

Vol. 11, No. 4, Year 2011 (Cover Date: October 2011)

Journal Editor: Apte M.V. (Sydney, NSW)
ISSN: 1424-3903 (Print), eISSN: 1424-3911 (Online)

For additional information: http://www.karger.com/PAN


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 12/29/2010
Accepted: 8/4/2011
Published online: 9/28/2011

Number of Print Pages: 8
Number of Figures: 4
Number of Tables: 3

ISSN: 1424-3903 (Print)
eISSN: 1424-3911 (Online)

For additional information: http://www.karger.com/PAN


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