Evaluation of the prognostic value of neutrophil to lymphocyte ratio in patients with hypertriglyceridemia-induced acute pancreatitis

Wang, Yuchen; Fuentes, Harry E; Attar, Bashar M.; Jaiswal, Palashkumar; Demetria, Melchor

doi:10.1016/j.pan.2017.10.001

Cited by 45 publications

(35 citation statements)

References 33 publications

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“…[10,30] A few of researches have explored the relationship between NLR, PLR, and AP. [9,10,31] Wang et al demonstrated that NLR had the highest discriminatory capacity for severe hypertriglyceridemia-induced AP. [31] Jeon and Park proved that elevated baseline NLR correlates with SAP and organ failure.…”

Section: Discussionmentioning

confidence: 99%

Severity stratification and prognostic prediction of patients with acute pancreatitis at early phase

et al. 2019

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Severity stratification and prognostic prediction at early stage is crucial for reducing the rates of mortality of patients with acute pancreatitis (AP). We aim to investigate the predicting performance of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and red-cell distribution width (RDW) combined with severity scores (sequential organ failure assessment [SOFA], bed-side index for severity of AP [BISAP], Ranson criteria, and acute physiology and chronic health evaluation II [APACHE II]) for severe AP (SAP) and mortality. A total of 406 patients diagnosed with AP admitted in a tertiary teaching hospital were enrolled. Demographic information and clinical parameters were retrospectively collected and analyzed. NLR, PLR, RDW, blood urea nitrogen (BUN), and AP severity scores (SOFA, BISAP, Ranson, and APACHE II) were compared between different severity groups and the survival and death group. Receiver-operating characteristic (ROC) curves for SAP and 28-day mortality were calculated for each predictor using cut-off values. Area under the curve (AUC) analysis and logistic regression models were performed to compare the performance of laboratory biomarkers and severity scores. Our results showed that NLR, PLR, RDW, glucose, and BUN level of the SAP group were significantly increased compared to the mild acute pancreatitis (MAP) group on admission ( P < .001). The severity of AP increased as the NLR, SOFA, BISAP, and Ranson increased ( P < .01). The AUC values of NLR, PLR, RDW, BUN, SOFA, BISAP, Ranson, and APACHE II to predict SAP were 0.722, 0.621, 0.787, 0.677, 0.806, 0.841, 0.806, and 0.752, respectively, while their AUC values to predict 28-day mortality were 0.851, 0.693, 0.885, 0.765, 0.968, 0.929, 0.812, and 0.867, respectively. BISAP achieved the highest AUC, sensitivity and NPV in predicting SAP, while SOFA is the most superior in predicting mortality. The combination of BISAP + RDW achieved the highest AUC (0.872) in predicting SAP and the combination of SOFA + RDW achieved the highest AUC (0.976) in predicting mortality. RDW (OR = 1.739), SOFA (OR = 1.554), BISAP (OR = 2.145), and Ranson (OR = 1.434) were all independent risk factors for predicting SAP, while RDW (OR = 7.361) and hematocrit (OR = 0.329) were independent risk factors for predicting mortality by logistic regression model. NLR, PLR, RDW, and BUN indicated good predictive value for SAP and mortality, while RDW had the highest discriminatory capacity. RDW is a convenient and reliable indicator for prediction not only SAP, but also mortality.

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Section: Discussionmentioning

confidence: 99%

Severity stratification and prognostic prediction of patients with acute pancreatitis at early phase

et al. 2019

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“…However, the study was limited by enrollment of patients only with etiology of gallstone or alcohol. Wang et al retrospectively reviewed 110 patients with HTG‐AP and concluded that NLR represents an inexpensive, readily available test with a promising value to predict disease severity in HTG‐AP. This was consistent with our results.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil‐to‐lymphocyte ratio can specifically predict the severity of hypertriglyceridemia‐induced acute pancreatitis compared with white blood cell

Huang

Chen

Yang

et al. 2019

Clinical Laboratory Analysis

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Objectives We aimed to evaluate the values of neutrophil‐to‐lymphocyte ratio (NLR) and white blood cell (WBC) in predicting severity of acute pancreatitis (AP) with different etiologies. Methods We compared NLR and WBC levels in patients with different etiologies and AP severity. The optimal cutoff value for them to predict severe acute pancreatitis (SAP) was determined by receiver operating characteristic (ROC) curve analysis. Results Both NLR and WBC were elevated in patients with SAP. After subgrouping AP by etiology, NLR was predictive of SAP only in hypertriglyceridemia‐induced AP (HTG‐AP), while WBC could effectively predict severity in both gallstone and HTG‐AP. The best cutoff value of WBC for predicting SAP in gallstone AP patients was 12.81 × 109/L, with sensitivity and specificity of 78.9% and 70.2%. The best cutoff value for NLR and WBC to differentiate HTG‐SAP was more than 5.88 and 15.89 × 109/L, respectively, with sensitivity and specificity of 87% and 50% for NLR and 56.5% and 75.76% for WBC. Conclusions Our study firstly demonstrated that NLR selectively played a role in HTG‐AP, while WBC could predict the severity of both gallstone and HTG‐AP. Furthermore, we firstly elucidated that NLR was more sensitive and accurate in judging the severity of HTG‐AP compared with WBC.

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“…9 As it constitutes parameters from both innate (neutrophil) and adaptive (lymphocyte) immune systems, it may be less affected by confounding variables, such as exercise, compared with other commonly used inflammatory biomarkers. 9 NLR has demonstrated reliable prognostic value across a range of physical health disorders, [10][11][12][13] highlighting a positive association between systemic inflammation and worse clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Neutrophil–lymphocyte ratio across psychiatric diagnoses: a cross-sectional study using electronic health records

Brinn

Stone

2020

BMJ Open

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ObjectivesThe main objective of this study was to compare neutrophil–lymphocyte ratio (NLR), a marker of systemic inflammation, between patients diagnosed with International Classification of Diseases 10th Revision (ICD-10) psychiatric disorders and control participants.DesignA cross-sectional methodology was employed to retrospectively analyse electronic health records and records derived from a national health survey.SettingA secondary mental healthcare service consisting of four boroughs in South London.ParticipantsA diverse sample of 13 888 psychiatric patients extracted from South London and Maudsley electronic health records database and 3920 control participants extracted from National Health and Nutrition Survey (2015–2016) were included in the study.Primary and secondary outcome measuresPrimary: NLR levels in patients with mental health diagnoses, NLR between patients with different mental health diagnoses. Secondary: relationship of NLR to length of hospitalisation and to mortality.ResultsNLR was elevated compared with controls in patients with diagnoses including dementia, alcohol dependence, schizophrenia, bipolar affective disorder, depression, non-phobic anxiety disorders and mild mental retardation (p<0.05). NLR also correlated with age, antipsychotic use and hypnotic use. NLR was found to be higher in individuals of ‘white’ ethnicity and lower in individuals of ‘black’ ethnicity. Elevated NLR was associated with increased mortality (β=0.103, p=2.9e−08) but not with hospital admissions or face-to-face contacts.ConclusionsElevated NLR may reflect a transdiagnostic pathological process occurring in a subpopulation of psychiatric patients. NLR may be useful to identify and stratify patients who could benefit from adjunctive anti-inflammatory treatment.

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Evaluation of the prognostic value of neutrophil to lymphocyte ratio in patients with hypertriglyceridemia-induced acute pancreatitis

Cited by 45 publications

References 33 publications

Severity stratification and prognostic prediction of patients with acute pancreatitis at early phase

Severity stratification and prognostic prediction of patients with acute pancreatitis at early phase

Neutrophil‐to‐lymphocyte ratio can specifically predict the severity of hypertriglyceridemia‐induced acute pancreatitis compared with white blood cell

Neutrophil–lymphocyte ratio across psychiatric diagnoses: a cross-sectional study using electronic health records

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