Diagnosis and treatment of severe acute pancreatitis: Current status and main problems

Value of neutrophil to lymphocyte ratio combined with red blood cell distribution width for predicting severity of acute pancreatitis

AIM

To explore the value of neutrophil to lymphocyte ratio (NLR) combined with red blood cell distribution width (RDW) for predicting the severity of acute pancreatitis (AP).

METHODS

The clinical data of 120 patients with AP were retrospectively analyzed in this study. The patients were assigned to three groups: mild AP (MAP) group, moderately severe AP (MSAP) group, and severe AP (SAP) group. The clinical indexes (NLR and RDW) of the three groups of patients were measured at 24 h after hospitalization. All of these data were compared among the groups, and between dead patients and surviving cases. The receiver operator characteristic curves (ROCs) of NLR, RDW, and NLR plus RDW were plotted to assess their value in predicting the prognosis of AP.

RESULTS

With the increase of the severity of AP, the value of NLR increased significantly (P < 0.05). There was no significant difference in RDW between the MAP and MSAP groups (P > 0.05). The RDW value of the SAP group was significantly different from those of the MAP and MSAP groups (P < 0.05). The values of NLR and RDW in the death group were significantly higher than those in the survival group (P < 0.05). The area under the curve of NLR in predicting AP severity was 0.794, which was significantly higher than that of RDW (0.745; P < 0.05). The area under the NLR + RDW curve was 0.876 (sensitivity, 0.795; specificity, 0.852), which was significantly higher than that of NLR and RDW alone (P < 0.05).

CONCLUSION

NLR and RDW are both related to the severity of AP, and the combination of the two indexes can improve the sensitivity and specificity of predicting the severity of AP.