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Use of the neutrophil to lymphocyte ratio compare crp for the early prediction of acute pancreatitis severity?

Edip Erdal Yilmaz, Zübeyir Bozdag, Ahmet Turkoglu, Burak Veli Ulger, Zulfu Arikanoglu, Omer Uslukaya, Yilmaz Zengin, Enver Ay, Metehan Gumus.




Abstract
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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.

Key words: Neutrophil; Lymphocyte Count; Pancreatitis.






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