Neutrophilic lymphocytic ratio as a prognostic indicator in acute pancreatitis

BACKGROUND: Acute pancreatitis is a common and a highly challenging clinical condition encountered in our day to day surgical practice. Severe pancreatitis being associated with high mortality, scoring systems has been devised to assess the severity. The Neutrophil-Lymphocyte Ratio (NLR) calculated from the WBC differential count provides a rapid indication of the extent of an inflammatory process. AIM OF THE STUDY: To investigate if Neutrophil- Lmphocyte Ratio (NLR) can act as a single indicator in assessing the prognosis of acute pancreatitis. MATERIALS AND METHODS: The NLR was calculated on 100 acute pancreatitis patients on day 0, day1 and day 2 of admission. The NLR obtained was correlated with the severity of pancreatitis using Atlanta classification. RESULTS: Of the 100 patients, 20 patients had severe acute pancreatitis. The NLR values calculated in severe acute pancreatitis was significantly higher than in mild acute pancreatitis on all 3 days (Day 0- 8.2 vs. 4.4; Day 1- 9.07 vs. 5.08; Day 2- 10.89 vs. 4.52). CONCLUSION: Elevation of Neutrophil Lymphocyte Ratio (NLR) during the first 48hrs of admission is significantly associated with severe acute pancreatitis and can be used as a simple, single, cost-effective indicator in assessing severity of acute pancreatitis