A prospective study to assess the use of preoperative neutrophil to lymphocyte ratio as a predictor of severe cholecystitis

Background: Cholecystitis can be divided into simple and severe cholecystitis. Untreated simple cholecystitis resolves within 7–10 days if it does not progress to more severe cholecystitis. Aims and objectives were to evaluate whether neutrophil-to-lymphocyte ratio can differentiate between simple cholecystitis and severe cholecystitis. To evaluate role of NLR as a prognostic indicator.Methods: The source of data for our study will be patients admitted in the department of general surgery diagnosed with acute cholecystitis in Konaseema Institute of medical sciences and research foundation, Amalapuram. All patients between 15 to 70 years of age with a clinical diagnosis of acute cholecystitis confirmed with histopathology study. Results: With an NLR value of 4.35, the sensitivity and specificity were 67% and 87%, respectively. Therefore, we considered 4.35 as the cutoff value, and divided the patient population into two groups: those with preoperative NLR values below 4.35 (n=50) and those with values equal to or greater than 4.35 (n=15). 53.33% of higher NLR group patients had severe cholecystitis compared to only 8 % of patients in lower NLR group (p<0.05). Conclusions: It was seen that the patients with cholecystitis can be divided into low risk (NLR<4.35) and high risk (NLR≥4.35) groups for severe cholecystitis as per the NLR value at admission.