Neutrophil to lymphocyte ratio predicts persistent organ failure and in-hospital mortality in an Asian Chinese population of acute pancreatitis

Zhang, Yushun; Wu, Wei; Dong, Liming; Yang, Chong; Fan, Ping; Wu, Heshui

doi:10.1097/md.0000000000004746

Cited by 33 publications

(30 citation statements)

References 26 publications

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“…In our previous researches, we found that admission parameters such as peripheral blood CD4+ T lymphocytes 22 , neutrophil to lymphocyte ratio 37 , mean platelet volume 38 , serum calcium 39 and lactate dehydrogenase 40 were independent risk factors for POF. The present finding that lower concentrations of admission HDL-C and LDL-C are associated with increased risk of adverse outcomes complements the evidence that decreased HDL-C correlates with acute phase responses.…”

Section: Discussionmentioning

confidence: 93%

Decreased high density lipoprotein cholesterol is an independent predictor for persistent organ failure, pancreatic necrosis and mortality in acute pancreatitis

Zhang

Guo

et al. 2017

Sci Rep

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High density lipoprotein cholesterol (HDL-C) has been reported as a significant indicator of systemic inflammation. The association underlying HDL-C and persistent organ failure (POF), pancreatic necrosis (PNec) and mortality in acute pancreatitis (AP) has not been evaluated. From 2007 to 2016, consecutive AP patients with admission lipid profiles assessment were included in this study. The association of HDL-C value and other lipids with outcomes was explored with Cox proportional regression models, which were adjusted for confounding factors. 1131 consecutive AP patients were clinically eligible. Overall, 17.9% of the patients developed with POF, 27.1% experienced PNec, and 6.7% died during hospitalization. Lower HDL-C median (<1.06 mmol/L) was identified as an independent prognostic factor of the outcomes. Moreover, there was a positive trend for the association across increasing HDL-C quartiles and POF, PNec and mortality after multivariable analysis (p values were <0.001, <0.001 and 0.043, respectively). The AUC of HDL-C for the outcomes were comparable to that of Ranson score for diagnosing POF (0.778 vs. 0.678; P < 0.001), PNec (0.734 vs. 0.701; P = 0.143) and mortality (0.768 vs. 0.745; P = 0.516). Decreased HDL-C value is an independent risk factor for the incidence of POF, PNec and in-hospital mortality in AP.

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Section: Discussionmentioning

confidence: 93%

Decreased high density lipoprotein cholesterol is an independent predictor for persistent organ failure, pancreatic necrosis and mortality in acute pancreatitis

Zhang

Guo

et al. 2017

Sci Rep

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“…Acute pancreatitis (AP) is an inflammatory process in which local pancreatic injury leads to systemic inflammation through activation of cytokine cascades [ 1 ]. The clinical extent of AP varies widely from no symptoms to systemic inflammatory response syndrome (SIRS), persistent organ failure (POF), and death [ 2 ]. The clinical presentation of AP is both unreliable and nonspecific and exhibits a sensitivity less than 40% for the prediction of adverse outcomes [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can predict the severity of gallstone pancreatitis

et al. 2018

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BackgroundNeutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) predict severity in various diseases. In this study, we evaluated the value of NLR and PLR as prognostic factors in acute pancreatitis (AP).MethodsPatients with AP were prospectively enrolled from March 2014 to September 2016 at Yonsei University Wonju College of Medicine. NLR and PLR were obtained at admission and were compared with other known prognostic scoring systems.ResultsA total of 243 patients were enrolled with an etiology of gallstone (n = 134) or alcohol (n = 109). NLR (17.7 ± 18.3 vs. 8.8 ± 8.4, P < 0.001) and PLR (344.1 ± 282.6 vs. 177.8 ± 150.1, P < 0.001) were significantly higher in the gallstone AP group than in the alcoholic AP group. For gallstone AP, NLR and PLR were significantly higher in severe AP, whereas high NLR and PLR were not related to severe AP in alcoholic AP. For the gallstone AP group, NLR and PLR demonstrated a predictive value significantly superior to C-reactive protein (CRP), whereas NLR, PLR, and CRP were not significant predictors for alcoholic AP.ConclusionOur study demonstrated that NLR and PLR can predict the severity of AP, but only in gallstone AP.

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“…[ [23][24][25] In recent years, several studies have reported that the use of NLR to evaluate associations between a viral [12,13] involvement and prognosis of infected patients. There is reason to believe that it is reasonable to predict the prognosis of patients with novel coronavirus by NLR.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio on Admission Predicts In-hospital Mortality in Patients with COVID-19

Zhou

Fang

et al. 2020

Preprint

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Background: A novel coronavirus caused an outbreak of acute infectious pneumonia are spreading over the globe. However, studies predicting prognosis are limited. We predicted outcomes of patients with coronavirus disease 2019 (COVID-19) using the neutrophil-to-lymphocyte ratio (NLR) on admission.Methods: We retrospectively analyzed the characteristics of COVID-19 patients diagnosed from February 6 to March 1. The outcomes, including the occurrence of in-hospital mortality, acute kidney injury (AKI), and endotracheal intubation (ETI), were recorded. The relationships of neutrophils, lymphocytes, C-reactive protein, lactate dehydrogenase, and NLR with outcomes were assessed using multivariate regression model. P-values for trends across quartiles of NLR was examined.Results: A total of 182 patients were included. 37 (20.3%) patients died during the hospitalization, 41 (22.5%) developed AKI, and 36 (19.8%) received ETI. The NLR had a superior predictive performance than others. Using an NLR cutoff of 11.4, the area under the curves (AUC) were 0.766 for in-hospital mortality, 0.755 for AKI, and 0.733 for ETI. In multivariate analysis, NLR >11.4 was further identified as an independent prognostic factor. Following stratification with quartiles of NLR, a positive trend between the increasing quartiles of NLR and the three outcomes were observed (p-values for trends across quartiles were 0.043, <0.001, and 0.041, respectively). The multivariate adjusted odds ratio (OR) in the highest quartile vs. the lowest quartile were 5.738 for mortality, 25.307 for AKI, and 5.136 for ETI.Conclusions: Increasing NLR obtained on admission is a powerful predictor for inpatient mortality, AKI, and ETI in COVID-19 patients.

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Neutrophil to lymphocyte ratio predicts persistent organ failure and in-hospital mortality in an Asian Chinese population of acute pancreatitis

Abstract: Supplemental Digital Content is available in the text

Cited by 33 publications

References 26 publications

Decreased high density lipoprotein cholesterol is an independent predictor for persistent organ failure, pancreatic necrosis and mortality in acute pancreatitis

Decreased high density lipoprotein cholesterol is an independent predictor for persistent organ failure, pancreatic necrosis and mortality in acute pancreatitis

Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can predict the severity of gallstone pancreatitis

Neutrophil-to-Lymphocyte Ratio on Admission Predicts In-hospital Mortality in Patients with COVID-19

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