Neutrophil-to-Lymphocyte Ratio as an Early Predictor of Complication and Mortality Outcomes in Individuals With Acute Pancreatitis at a UK District General Hospital: A Retrospective Analysis

Halaseh, Sattam A; Kostalas, Marcos; Kopec, Charles A; Toubasi, Ahmad A.; Salem, Rola

doi:10.7759/cureus.29782

Cited by 3 publications

(3 citation statements)

References 21 publications

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Section: Discussionmentioning

confidence: 99%

“…Therefore, since these parameters used in daily practice are increased in many diseases, their use may not be safe in predicting severe pancreatitis, just like CRP, as seen in our results. [12,[33][34][35] The main limitation of our study was its small sample size. No statistically significant differences were found between the mild and moderate pancreatitis groups.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between salusin beta levels and the severity of acute pancreatitis in patients

Albayrak,

Guneyin,

Celik

2024

Medicine

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Background: This study aimed to evaluate the significance of serum salusin beta (SAL-β) levels in predicting the severity of acute pancreatitis (AP) in patients diagnosed with this condition and to assess its relationship with disease and prognosis. Methods: Sixty-four patients between 18 and 100 years of age diagnosed with AP, were included in the study. Patients were categorized into 3 groups based on the Revised Atlanta Classification: mild, moderate, and severe AP. Eighteen healthy adults were included as the control group. Sex, age, height, weight, presence of additional diseases, laboratory results, imaging findings, levels of white blood cells, neutrophil-lymphocyte ratio, mean platelet volume, amylase, lipase, sensitive C-reactive protein, sedimentation, and serum SAL-β were measured and recorded. SAL-β levels were reevaluated on the third day of hospitalization. Results: The average age of the patients included in the study was 62.66 ± 17.67. Gallstones were present in 64.1% of the patients. The difference in the SAL-β averages on the 1st and 3rd days was statistically significant (P < .05). On the first day, the SAL-β averages of those with severe Atlanta scores were higher than those with mild and moderate Atlanta severity. Similarly, on the third day, the SAL-β averages of those with severe Atlanta scores were higher than those with mild and moderate Atlanta severity. According to receiver operating characteristic analysis using the Youden index, the cutoff value for SAL-β for severe pancreatitis was 178.8 pg/mL on the 1st day and 207.5 pg/mL on the 3rd day. Conclusion: SAL-β can be used to detect and monitor severe pancreatitis. Further extensive clinical studies with larger case series are needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Relationship between salusin beta levels and the severity of acute pancreatitis in patients

Albayrak,

Guneyin,

Celik

2024

Medicine

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“…and for predicting organ failure, it was 4.88 [18]. Research by Halaseh et al [19] indicated that NLR could predict the severity of AP at initial diagnosis and might forecast adverse outcomes, the need for intensive care, and the length of hospital stay. These studies demonstrate that NLR is a useful biomarker for predicting the severity of acute pancreatitis early in the disease course.…”

Section: Plos Onementioning

confidence: 99%

Construction and alidation of a severity prediction model for acute pancreatitis based on CT severity index: A retrospective case-control study

Han,

Hu,

et al. 2024

PLoS ONE

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To construct and internally and externally validate a nomogram model for predicting the severity of acute pancreatitis (AP) based on the CT severity index (CTSI).A retrospective analysis of clinical data from 200 AP patients diagnosed at the Hefei Third Clinical College of Anhui Medical University from June 2019 to June 2022 was conducted. Patients were classified into non-severe acute pancreatitis (NSAP, n = 135) and severe acute pancreatitis (SAP, n = 65) based on final clinical diagnosis. Differences in CTSI, general clinical features, and laboratory indicators between the two groups were compared. The LASSO regression model was used to select variables that might affect the severity of AP, and these variables were analyzed using multivariate logistic regression. A nomogram model was constructed using R software, and its AUC value was calculated. The accuracy and practicality of the model were evaluated using calibration curves, Hosmer-Lemeshow test, and decision curve analysis (DCA), with internal validation performed using the bootstrap method. Finally, 60 AP patients treated in the same hospital from July 2022 to December 2023 were selected for external validation.LASSO regression identified CTSI, BUN, D-D, NLR, and Ascites as five predictive factors. Unconditional binary logistic regression analysis showed that CTSI (OR = 2.141, 95%CI:1.369–3.504), BUN (OR = 1.378, 95%CI:1.026–1.959), NLR (OR = 1.370, 95%CI:1.016–1.906), D-D (OR = 1.500, 95%CI:1.112–2.110), and Ascites (OR = 5.517, 95%CI:1.217–2.993) were independent factors influencing SAP. The established prediction model had a C-index of 0.962, indicating high accuracy. Calibration curves demonstrated good consistency between predicted survival rates and actual survival rates. The C-indexes for internal and external validation were 0.935 and 0.901, respectively, with calibration curves close to the ideal line.The model based on CTSI and clinical indicators can effectively predict the severity of AP, providing a scientific basis for clinical decision-making by physicians.

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Neutrophil to Lymphocyte Ratio Predicts Infections in First Week of Acute Pancreatitis

Kumbhar,

Kurien,

Joseph

et al. 2024

Preprint

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Background Differentiating infections from sterile inflammation is crucial in early AP management. Aim This study aimed to analyse the source, microbiological profile, and impact of infections in AP and to assess the capability of Neutrophil to Lymphocyte Ratio(NLR) and procalcitonin to discriminate between sterile inflammation and infections in the first week of illness. Methods Consecutive patients presenting within 5 days of symptom onset were included. Microbiological profiles and serious adverse events(SAEs:in-hospital mortality or discharge in critical state)were analysed. Blood count obtained at fever onset was used for calculating the NLR. The ability of NLR and procalcitonin to discriminate infection from sterile inflammation in the first week was assessed. Results Of 505 AP patients, 150 developed fevers. 48(32%)had sterile inflammation while 102(68%)had infections. Within infections,44 had infected pancreatic necrosis, 68 had extra-pancreatic infections,and 10 had both.Lower respiratory tract infection was the most common extra-pancreatic infection.Of 54 patients with culture-positive infections, 36(66.7%)had grown multidrug-resistant(MDR) organisms. Fungal isolates were identified in 5 patients. Patients with infections had higher SAE incidence(21.6% vs 4.2%,p = 0.007)than those with sterile inflammation. The SAE incidence was higher with MDR infections than those without MDR(37.5% vs 9.3%,p < 0.01).Most patients(n = 98,65.3%) developed fever during the first week of illness(sterile inflammation(n = 43)& infections(n = 55)).NLR demonstrated good accuracy in discriminating infections from sterile inflammation in the first week(AUROC 0.70,p = 0.001),outperforming procalcitonin(AUROC 0.54,p = 0.58). Conclusions Infections in AP occur early in the course of illness. NLR could serve as a reliable biomarker to distinguish infections from sterile inflammation in the early course of AP,aiding timely management. Patients with MDR infections have higher serious adverse outcomes.

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Neutrophil-to-Lymphocyte Ratio as an Early Predictor of Complication and Mortality Outcomes in Individuals With Acute Pancreatitis at a UK District General Hospital: A Retrospective Analysis

Cited by 3 publications

References 21 publications

Relationship between salusin beta levels and the severity of acute pancreatitis in patients

Relationship between salusin beta levels and the severity of acute pancreatitis in patients

Construction and alidation of a severity prediction model for acute pancreatitis based on CT severity index: A retrospective case-control study

Neutrophil to Lymphocyte Ratio Predicts Infections in First Week of Acute Pancreatitis

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