Role of Neutrophil-Lymphocyte Ratio (NLR) in predicting development of organ failure in Acute Pancreatitis

Mediscope ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 45-52
Author(s):  
Khan Md Nazmus Saqeb ◽  
Abu Khalid Muhammad Maruf Raza
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
High Sensitivity ◽  
Cost Effective ◽  
Clinical Parameters ◽  
Biochemical Tests ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Single Marker

Background: Different modalities are available for predicting development of organ failure in Acute Pancreatitis. A single marker with high sensitivity and specificity is yet to be identified. This study intends to find out the utility of Neutrophil Lymphocyte Ratio (NLR) in predicting development of organ failure in Acute Pancreatitis. Methods: A total of 117 patients admitted with acute pancreatitis were included. Clinical parameters and biochemical tests were recorded on admission and on day 3 & day 5 of admission. CT scan was performed in all patients. NLRwas calculated using these data.Every patient was followed regularly for identification of organ failure. Statistical analysis was done with SPSS V22. Results: Among 117 patients, 67(57.3%) were male and 50(42.73%) were female with a mean age of 47.99±15. Among the patients the etiology was found to be biliary, hypertriglyceridemia, alcohol, malignancy and post-ERCP complications in 25(21.4%),23(19.7%),8(6.8%),3(2.6%),2(1.7%) cases respectively. In 53(45.3%) cases no definite etiology could be found. 83(70.9%) patients had mild,15(12.8%) had moderately severe and 19(16.2%) had severe acute pancreatitis. 23 (19.65%) patients developed complication, whereas 94 (80.34%) developed no complication.Organ failure was present in 34(29.06%) cases among total 117 cases.Those patients who developed organ failure had a mean NLR of 6.25±0.96, in contrast to a mean of 3.64±0.50 in those who didn’t developed organ failure.ROC curve evaluating the role of NLR in predicting development of organ failure in acute pancreatitis showed an AUC of 0.984. ROC curve revealed a cutoff point of 5.04 with highest sensitivity (97.1%) & specificity (97.6%) with a PPV & NPV of 94.3% & 98.8% respectively. Conclusion: Calculating NLR is simple, it is readily available, easy to assess and cost-effective. It can be used as a new simple & cost-effective marker for the prediction of development of organ failure in Acute Pancreatitis. Mediscope Vol. 8, No. 1: January 2021, Page 45-52

scholarly journals Serum Procalcitonin in the Prediction of Severity and Outcome of Acute Pancreatitis

2021 ◽  
Vol 9 (1) ◽  
pp. 16-21
Author(s):  
Khan Md Nazmus Saqeb
Keyword(s):  
Acute Pancreatitis ◽  
Statistical Analysis ◽  
Severe Disease ◽  
High Sensitivity ◽  
Biochemical Tests ◽  
Single Marker ◽  
Predicting Outcome ◽  
The Mean ◽  
The Difference

Background: Different modalities are available for predicting severity and outcome of acute pancreatitis. A single marker with high sensitivity and specificity is yet to be identified. Aim: This study intends to find out the utility of serum procalcitonin in predicting the severity and outcome of acute pancreatitis. Methods: 117 patients admitted with acute pancreatitis were included.Clinical parameters and biochemical tests were recorded on admission, on day-3 & day-5 of admission. CT scan was performed in all patients. Serum procalcitonin was done on admission. Multifactorial scores were calculated using these data.Every patient was followed for identification of organ failure or other complications. Statistical analysis was done with SPSS. Result: Among 117 patients, 67(57.3%) were male. Biliary, hypertriglyceridemia, alcohol, malignancy and post-ERCP complications were found as aetiology in 25(21.4%), 23(19.7%), 8(6.8%), 3(2.6%),2(1.7%) cases respectively. In 53(45.3%) cases no definite etiology could be found. 83(70.9%) patients had mild,15(12.8%) had moderately severe and 19(16.2%) had severe acute pancreatitis. 23(19.65%) patients developed complication, whereas 94 (80.34%) developed none. The mean serum procalcitonin(pg/ml) of patients with mild, moderately severe and severe disease was 146±165.21, 1297±439.44, 4361±1493.55 respectively. The difference among the groups were statistically significant. Mean serum procalcitonin(pg/ml) in patientswho developed complications was 3744±1827.05 and in those without complication it was 301±559.97.ROC curve evaluating the role of serum procalcitonin in predicting outcome of acute pancreatitis showed AUC of 0.985. A cutoff point of 1131.28pg/ml showed highest sensitivity (95.7%) & specificity (94.7%). Conclusion: Serum procalcitonin can be a new promising marker to predict severity and outcome of acute pancreatitis. Bangladesh Crit Care J March 2021; 9(1): 16-21

scholarly journals Role of Clinical Profile, Comorbidities and Neutrophil Lymphocyte Ratio on Prognosis of Acute Pancreatitis

2017 ◽  
Author(s):  
Sreenivasa Rao Sudulagunta ◽  
Monica Kumbhat ◽  
Mahesh Babu Sudulagunta ◽  
Aravinda Settikere Nataraju ◽  
Shiva Kumar Bangalore Raja
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Profile ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

The role of coinfection with influenza viruses in the pathogenesis of severe infection in patients with COVID-19

2021 ◽  
Vol 21 (3) ◽  
pp. 159-164
Author(s):  
Tamara N. Shvedova ◽  
Olga S. Kopteva ◽  
Polina A. Kudar ◽  
Anna A. Lerner ◽  
Yuliya A. Desheva
Keyword(s):  
Influenza A ◽  
Fold Increase ◽  
Igg Antibodies ◽  
C Reactive Protein ◽  
S Protein ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Coronavirus Infection

BACKGROUND: Despite the continuing global spread of the coronavirus infection COVID-19 caused by the SARS-CoV-2 coronavirus, the mechanisms of the pathogenesis of severe infections remain poorly understood. The role of comorbidity with other seasonal viral infections, including influenza, in the pathogenesis of the severe course of COVID-19 remains unclear. MATERIALS AND METHODS: The present study used sera left over from ongoing laboratory studies of patients with varying degrees of severity of COVID-19. The study was approved by the Local Ethics Committee of the Federal State Budgetary Scientific Institution IEM (protocol 3/20 from 06/05/2020). We studied 28 paired samples obtained upon admission of patients to the hospital and after 57 days of hospital stay. Paired sera of patients with COVID-19 were tested for antibodies to influenza A and B viruses. The presence of IgG antibodies specific to the SARS-CoV-2 spike (S) protein was studied using an enzyme-linked immunosorbent assay (ELISA). The serum concentration of C-reactive protein and the neutrophil-lymphocyte ratio on the day of hospitalization were also assessed. RESULTS: At least a 4-fold increase in serum IgG antibodies to SARS-CoV-2 S protein was found both in patients with PCR-confirmed SARS-CoV-2 infection and without PCR confirmation. It was shown that out of 18 patients with moderate and severe forms of COVID-19 infection, six of them showed at least a 4-fold increase in antibodies to influenza A/H1N1, in one to influenza A/H3N2 and in two cases to the influenza B. Laboratory data in these two groups were characterized by significant increases in serum C-reactive protein and neutrophil-lymphocyte ratio concentrations compared with the moderate COVID-19 group. CONCLUSIONS: Serological diagnostics can additionally detect cases of coronavirus infection when the virus was not detected by PCR. In moderate and severe cases of COVID-19, coinfections with influenza A and B viruses have been identified. The results obtained confirm the need for anti-influenza immunization during the SARS-CoV-2 pandemic. Influenza virus screening can significantly improve patient management because recommended antiviral drugs (neuraminidase inhibitors) are available.

scholarly journals ROLE OF HEMATOLOGICAL PARAMETERS IN EARLY DIAGNOSIS OF COVID-19 IN A TERTIARY CARE CENTRE

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Angira Saha ◽  
Sakar Saxena ◽  
Romi Srivastava ◽  
Sanjeev Narang
Keyword(s):  
Early Diagnosis ◽  
Hematological Parameters ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Significant Difference

Aim: To evaluate the role of biomarkers from blood samples of COVID-19 patients admitted in Index Medical College Hospital & R.C. Material & Methods: Hematological parameters such as Neutrophil lymphocyte ratio (NLR), Platelet lymphocyte ratio (PLR) & Systemic Inflammatory Index (SII) were studied in RT-PCR positive patients to evaluate the utility of these parameters for early diagnosis of COVID-19. Results: The study showed that there was statistically significant difference in test groups in reference to Neutrophil lymphocyte ratio (NLR) & SII values (p<0.05). But no statistically significant difference was observed between test groups in reference to Platelet lymphocyte ratio (PLR) values (p>0.05). Conclusion: Leukocyte, Neutrophil, NLR & SII values can be used in the early diagnosis of COVID-19. Keywords: NLR, SII, Leukocyte, Neutrophil

Neutrophils, lymphocytes and their ratio as predictors of outcome in patients with COVID-19

2021 ◽  
pp. 34-41
Author(s):  
Б.И. Кузник ◽  
Ю.Н. Смоляков ◽  
В.Х. Хавинсон ◽  
К.Г. Шаповалов ◽  
С.А. Лукьянов ◽  
...  
Keyword(s):  
Roc Analysis ◽  
Predictive Ability ◽  
High Sensitivity ◽  
Roc Curves ◽  
Threshold Values ◽  
Predictors Of Outcome ◽  
Timely Manner ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Early Stages

Актуальность. До сих пор в литературе практически не существует работ, в которых бы описывались на ранних стадиях COVID-19 простые методы исследования, позволяющие прогнозировать исход этого коварного заболевания. Вместе с тем, наличие предикторов благоприятного и летального исходов при COVID-19 имеет важное значение, так как своевременно позволяет клиницисту вмешаться в тактику лечения больного. Цель исследования - разработка простых и доступных предикторов, позволяющих с большой долей вероятности на ранних стадиях заболевания COVID-19 прогнозировать его исход. Методика. Исследования проведены на 125 больных COVID-19, у которых на 1-, 5-, 7-, 10-, 14-е и 21-е сут пребывания в стационаре определялось число лейкоцитов, нейтрофилов, лимфоцитов и отношение нейтрофилы/лимфоциты (NEU/LYM). Для расчета пороговых значений выживаемости и летальности, имеющих предиктивную ценность, проводился ROC-анализ. Для оценки значимости роста AUC в динамике заболевания сопоставление ROC кривых производили попарно (1-5, 5-7, 7-10, 10-14 и 14-е - 21-е сут с использованием непараметрического алгоритма E.R. DeLong. Результаты. Установлено, что между числом лейкоцитов, нейтрофилов, лимфоцитов и отношением NEU/LYM у больных с благоприятным исходом и больных впоследствии умерших существуют значительные различия. Наиболее значимыми предикторами исхода заболевания при COVID-19 являются число нейтрофилов и особенно индекс NEU/LYM, при повышении которого резко возрастает вероятность летального исхода. С помощью ROC-анализа установлено, что уже в 1-е сут заболевания предсказательная способность (AUC) для отношения NEU/LYM в качестве предиктора исхода заболевания соответствовала 79%, к 5-м сут 84%, начиная с 10-х сут и до окончания исследования баланс качества этого теста превышал 90%. При высоких значениях показателей возможного летального исхода необходимо вводить иммуномодуляторы. Мы рекомендуем с этой целью применять комплекс полипептидов вилочковой железы - тималин, хорошо зарекомендовавший себя при лечении больных со среднетяжелым и тяжелым течением COVID-19. Заключение. Предиктором тяжелого течения и неблагоприятного исхода COVID-19 с высокой чувствительностью и специфичностью является отношение нейтрофилы/лимфоциты (индекс NEU/LYM). Background. There have been practically no reports that describe, in early stages of COVID-19, simple methods to predict the outcome of this insidious disease. At the same time, predictors of favorable or fatal COVID-19 outcome are important, since they would allow clinicians to adjust treatment in a timely manner. Aim. To develop simple and affordable predictors that are highly likely to forecast outcome at early stages of COVID-19. Methods. The study was conducted in 125 patients with COVID-19, in whom the number of leukocytes, neutrophils, lymphocytes, and the neutrophil/lymphocyte ratio (NEU/LYM) were determined on days 1, 5, 7, 10, 14, and 21 of hospitalization. To calculate predictive threshold values of survival and mortality, ROC analyses were performed. To assess the significance of changes in the areas under the ROC curves (AUC) in the illness dynamics, the ROC curves were compared in pairs (1-5, 5-7, 7-10, 10-14, 14-21 days) using the DeLong nonparametric algorithm. Results. There were significant differences between the number of leukocytes, neutrophils, lymphocytes, and the NEU/LYM ratio in patients with a favorable outcome and those that later died. The most significant outcome predictors were the number of neutrophils and, especially, the NEU/LYM index, with an increase in which, the likelihood of death sharply increased. The ROC-analysis showed that on day 1, the outcome predictive ability of AUC for the NEU/LYM ratio was 79%; by day 5, it increased to 84%; from day 10 to day 21, it exceeded 90 %. In the presence of high indicators for potentially lethal outcomes, it is necessary to administer immunomodulators. For this purpose, we recommend using a complex of polypeptides from the thymus gland, i.e., thymalin, which has proven beneficial for treatment of patients with moderate to severe COVID-19. Conclusion. The neutrophil/lymphocyte ratio predicts of the outcome of severe COVID-19 with high sensitivity and specificity.

Evaluation of neutrophil–lymphocyte ratio in predicting bloodstream infection

2019 ◽  
Vol 13 (15) ◽  
pp. 1255-1261 ◽  
Author(s):  
Jian Qu ◽  
Hai-Yan Yuan ◽  
Ying Huang ◽  
Qiang Qu ◽  
Zhan-Bo Ou-Yang ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Study Group ◽  
Healthy Controls ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Gram Positive Bacteria ◽  
Diagnostic Indicator

Aim: The prognostic role of neutrophil-to-lymphocyte ratio (NLR) in bloodstream infection (BSI) deserves further investigation. Patients & methods: The NLR values were measured and compared in BSI patients and healthy controls. The receiver operating characteristic of NLR and cut-off values were measured in BSI patients and subgroups. Results: We have measured the NLR of study group with 2160 BSI patients and normal group with 2523 healthy controls, which was significantly high in study group (11.36 ± 21.38 vs 2.53 ± 0.86; p < 0.001) and the area under the curve was 0.834 (95% CI: 0.825–0.842; p < 0.001). The critical value of NLR for diagnosis of BSI was 3.09, with a sensitivity of 75.3%, and a specificity of 93.6%. Conclusion: NLR is an effective diagnostic indicator of including BSIs of Gram-negative bacteria, Gram-positive bacteria and fungus.

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