Diagnostic value of neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and systemic immune-inflammation index for predicting the severity of acute pancreatitis

Abstract

BACKGROUND: Acute pancreatitis (AP) is a serious condition, and the current diagnostic systems for AP are often time-consuming, and challenging to use outside intensive care, as they involve multiple variables. The diagnostic value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) for determining the severity of acute pancreatitis (AP) was investigated. METHODS: This is a Single-center, retrospective study. Various serologic and clinical parameters on admission of all patients with AP from April 1, 2018, to April 1, 2023, at Shahid Beheshti Hospital in Hamadan, Iran, were investigated. The NLR, PLR, and SII were measured upon admission and compared with the modified Computed Tomography Severity Index. The area under the Receiver operating characteristic (ROC) curve was used to assess the discriminative ability of NLR, PLR, and SII in AP. RESULTS: Overall, 112 patients were included, of whom 73 (65.2%) had mild acute pancreatitis (MAP), and 39 (34.8%) had moderate and severe AP. The area under the ROC curve for all three ratios in the multivariate model was estimated to be approximately 74%. The diagnostic ability of the three variables examined for assessing the severity of AP varied, with PLR demonstrating superior diagnostic capability (Youden index = 0.425). For the PLR cutoff point of 21.14, the sensitivity for diagnosing moderate and severe cases was 63.89%, while specificity for mild cases was 78.57%. For the NLR cutoff of 6.23, sensitivity was 77.78% and specificity was 62.86%. For the SII cutoff at 2046, sensitivity dropped to 55.56%, but specificity improved to 84.29%. CONCLUSION: The study suggests that the PLR has better diagnostic capability, while the NLR has the highest sensitivity, and the SII shows the highest specificity. TRIAL REGISTRATION: Not applicable.