Abstract:
Aim: To determine the usefulness of the neutrophil to lymphocyte ratio (NLR) as a diagnostic tool for the early detection and
prediction of acute pancreatitis (AP) severity compared with that of C-reactive protein (CRP).
Material and Methods: The medical records of 464 patients hospitalized with AP between 2006 and 2014 were reviewed. The patients
were classified into two groups: severe AP (SAP) and mild/moderate AP groups. Lymphocyte and neutrophil counts and CRP levels
at the time of admission were noted.
Results: Out of the total number of patients (n = 464), 67 had severe AP. The median NLR was significantly higher in the SAP group
(median of 11.1) than in the mild/moderate AP group (median of 6.9) (p < 0.0001). The sensitivity and specificity of NLR were 83.6%
and 49.4%, respectively, with a cut-off value of 6.8 and an AUC of 0.68. CRP levels were also significantly higher in the SAP group
(median of 189 mg/L) than in the mild/moderate AP group (median of 53.5 mg/L) (p < 0.0001). The sensitivity and specificity of the
CRP values were 83.6 % and 74.9 %, respectively, with a cut-off value of 113 mg/L and an AUC of 0.83.
Conclusion: The NLR was significantly higher in patients with severe AP. However, CRP measurement was superior to NLR as an early
predictor of severe disease.
