ISSN 2348-313X (Print) International Journal of Life Sciences Research ISSN 2348-3148 (online) Vol. 9, Issue 3, pp: (1-8), Month: July - September 2021, Available at: www.researchpublish.com
Neutrophil-Lymphocyte Ratio for Predicting Mortality among Adult Patients with Acute Pancreatitis: A Meta-Analysis 1
Joema D. Tabanda, M.D., 2Allen M. Quirit, M.D, 3 Benjamin T. Castro Jr, M.D, FPCP, FPSG, FPSDE Author: 1
World Citi Medical Center
960 Aurora Blvd, Project 4, Quezon City, Metro Manila Co-authors: 2
World Citi Medical Center
960 Aurora Blvd, Project 4, Quezon City, Metro Manila 3
IM –Gastroenterologist Consultant World Citi Medical Center
960 Aurora Blvd, Project 4, Quezon City, Metro Manila
Abstract: Acute pancreatitis (AP) is one of the most common gastrointestinal diseases in hospitalized patients. Numerous severity indicators have been described till date, most of which require reassessment after admission and resuscitation. Neutrophil-to-lymphocyte ratio (NLR) is a biological marker that has been shown to predict the mortality of Acute Pancreatitis. Current scoring systems for AP diagnosis are complicated, whereas NLR is a simple, practical, and effective marker. Objectives: To evaluate NLR as an independent prognostic factor for mortality among adults with AP Methods: We screened cohort studies through Cochrane, Embase, Medline, PubMed in investigating the association between NLR and mortality in AP adult patients up to June, 2020. The primary outcome was mortality. Pooled risk ratio, sensitivity, specificity, and an area under the receiver operating characteristic curve (AUC) was performed by a statistician Results: Out of the 151 studies searched, there were 5 studies (N= 1999) which met the inclusion criteria for this meta-analysis. Forrest plot analysis showed that elevated NLR (> 12) is associated with 11.5 times increased risk of dying among adult patients with AP (p-value<0.0001, 95%CI: 6.86 to 19.54). NLR has a pooled high sensitivity of 86 %; (p value 0.85, 95%, CI: 78-92%) and a specificity of 73%; (p value 0, 95%CI: 64 to 80%). The pooled accuracy was also high 88% (95%CI=85 to 91%) Conclusions: In patients with AP, NLR is an independent prognostic factor for mortality among adults with AP. A NLR (>12), is associated with higher risk of mortality. Keywords: Acute Pancreatitis; Mortality; Neutrophil to lymphocyte ratio. NLR.
I. INTRODUCTION AP is characterized by acute inflammation of the pancreas in patients with upper abdominal pain. AP may present as abdominal pain located at the epigastric or left upper-quadrant and may radiate to the back., The diagnosis is established by two of the following three criteria (1) typical abdominal pain in the epigastrium that may radiate to the back, (2)
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