The Neutrophil-Lymphocyte Ratio as an Early Predictive Marker of the Severity of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients and Data Collection
2.2. Study Outcomes and Definitions
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Mild-to-Moderate Post-ERCP Pancreatitis (n = 107) | Severe Post-ERCP Pancreatitis (n = 18) | p-Value | |
---|---|---|---|
Age, mean ± SD, years | 67.07 ± 13.62 | 60.94 ± 15.01 | 0.084 |
Male, gender, n (%) | 52 (48.6%) | 8 (44.4%) | 0.803 |
Indication for ERCP | |||
Benign | 70 (65.4%) | 15 (83.3%) | 0.13 |
Malignancy | 37 (34.6%) | 3 (16.7%) | |
Purpose of ERCP | |||
Diagnostic | 2 (1.9%) | 0 (0%) | 1.000 |
Therapeutic | 105 (98.1%) | 18 (100%) | |
BISAP score (on the first post-ERCP day) | 1.07 ± 0.58 | 2.44 ± 0.61 | <0.001 |
SIRS within 48 h, n (%) | 23 (21.5%) | 14 (77.8%) | <0.001 |
Prophylactic pancreatic stent | 12 (11.2%) | 0 (0%) | 0.212 |
Laboratory data (on the first post-ERCP day) | |||
Hematocrit, % | 36.31 ± 4.91 | 37.75 ± 4.25 | 0.245 |
WBC count (×103/µL) | 8.05 ± 3.01 | 11.91 ± 4.84 | 0.004 |
CRP (mg/dL) | 1.75 ± 2.13 | 2.91 ± 3.13 | 0.05 |
Glucose (mg/dL) | 124.39 ± 43.74 | 107.39 ± 19.88 | 0.108 |
BUN (mg/dL) | 15.2 ± 6.88 | 12 ± 3.96 | 0.058 |
Calcium (mg/dL) | 8.85 ± 0.46 | 8.82 ± 0.51 | 0.784 |
Albumin (g/dL) | 3.65 ± 0.39 | 3.5 ± 0.49 | 0.149 |
Hospital stay (d) | 8.84 ± 3.74 | 23.39 ± 16.04 | 0.001 |
Neutrophil–Lymphocyte Ratio | Mild/Moderate PEP (n = 107) | Severe PEP (n = 18) | p-Value |
---|---|---|---|
NLR before ERCP | 3.34 (1.68) | 2.26 (1.49) | 0.499 |
NLR on day 1 | 6.58 (5.21) | 11.19 (10.95) | 0.001 |
NLR on day 2 | 5.32 (4.98) | 15.68 (13.06) | <0.001 |
Variable | Odds Ratio (95% CI) | p-Value |
---|---|---|
Malignancy | 0.37 (0.1–1.39) | 0.175 |
BISAP score ≥ 3 points | 10.2 (2.7–38.52) | 0.001 |
WBC count > 10,000/µL | 8.1 (2.63–24.87) | <0.001 |
CRP > 1 mg/dL | 2.96 (0.98–8.89) | 0.073 |
BUN > 24 mg/dL | 0.84 (0.78–0.91) | 0.388 |
Glucose > 126 mg/dL | 0.51 (0.13–1.9) | 0.396 |
Systemic inflammatory response syndrome | 12.78 (3.83–42.5) | <0.001 |
NLR on day 1 > 7.38 | 5.58 (1.84–16.91) | 0.002 |
NLR on day 2 > 8.17 | 24.72 (6.47–94.3) | <0.001 |
Variable | Odds Ratio (95% CI) | p-Value |
---|---|---|
BISAP score ≥ 3 points | 9.07 (1.61–50.99) | 0.012 |
CRP > 1 mg/dL | 2.47 (0.42–14.28) | 0.312 |
NLR on day 1 > 7.38 | 0.87 (0.13–5.67) | 0.884 |
NLR on day 2 > 8.17 | 18.29 (4.5–73.5) | <0.001 |
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Lee, S.H.; Lee, T.Y.; Cheon, Y.K. The Neutrophil-Lymphocyte Ratio as an Early Predictive Marker of the Severity of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis. Medicina 2022, 58, 13. https://doi.org/10.3390/medicina58010013
Lee SH, Lee TY, Cheon YK. The Neutrophil-Lymphocyte Ratio as an Early Predictive Marker of the Severity of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis. Medicina. 2022; 58(1):13. https://doi.org/10.3390/medicina58010013
Chicago/Turabian StyleLee, Sang Hoon, Tae Yoon Lee, and Young Koog Cheon. 2022. "The Neutrophil-Lymphocyte Ratio as an Early Predictive Marker of the Severity of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis" Medicina 58, no. 1: 13. https://doi.org/10.3390/medicina58010013