scholarly journals The Neutrophil-Lymphocyte Ratio as an Early Predictive Marker of the Severity of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 13
Author(s):  
Sang Hoon Lee ◽  
Tae Yoon Lee ◽  
Young Koog Cheon
Keyword(s):  
Acute Pancreatitis ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Prognostic Markers ◽  
Area Under The Curve ◽  
Predictive Marker ◽  
Optimal Cutoff ◽  
Endoscopic Retrograde ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Index Of Severity

Background and objectives: Factors predictive of severe non-iatrogenic acute pancreatitis have been investigated, but few studies have evaluated prognostic markers of severe post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). The neutrophil–lymphocyte ratio (NLR) has been studied for predicting severe acute pancreatitis. We examined the predictive value of NLR in patients with PEP. Materials and Methods: From January 2012 to August 2021, 125 patients who developed PEP were retrospectively evaluated. The NLR was measured before, and on days 1 and 2 after, ERCP. PEP was categorized as mild, moderate, or severe according to consensus guidelines, based on the prolongation of planned hospitalization. Patients were divided into two groups, mild-to-moderate vs. severe PEP. Results: We analyzed 125 patients with PEP, 18 (14.4%) of whom developed severe PEP. The baseline NLR was similar between the two groups (2.26 vs. 3.34, p = 0.499). The severe PEP group had a higher NLR than the mild/moderate PEP group on days 1 (11.19 vs. 6.58, p = 0.001) and 2 (15.68 vs. 5.32, p < 0.001) post-ERCP. The area under the curve of the NLR on days 1 and 2 post-ERCP for severe PEP was 0.75 (95% confidence interval (CI), 0.64–0.86)) and 0.89 (95% CI, 0.81–0.97), respectively; NLR on day 2 had greater power to predict severe PEP. The optimal cutoff value of the NLR on days 1 and 2 after ERCP for prediction of severe PEP was 7.38 (sensitivity, 72%; specificity, 69%) and 8.17 (sensitivity, 83%; specificity, 83%), respectively. In a multivariate analysis, a Bedside Index of Severity in Acute Pancreatitis score ≥3 (odds ratio (OR) 9.07, p = 0.012) and NLR on day 2 > 8.17 (OR 18.29, p < 0.001) were significantly associated with severe PEP. Conclusions: The NLR on day 2 post-ERCP is a reliable prognostic marker of severe PEP.

ID: 3522056 PROGNOSTIC SCORES IN POST-ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY ACUTE PANCREATITIS: IS THERE A BETTER OPTION?

2021 ◽  
Vol 93 (6) ◽  
pp. AB151
Author(s):  
Vítor Macedo Silva ◽  
Marta Freitas ◽  
Rui S. Magalhães ◽  
Tiago Cúrdia Gonçalves ◽  
Pedro Boal Carvalho ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Prognostic Scores ◽  
Endoscopic Retrograde

Trends in the Use of Endoscopic Retrograde Cholangiopancreatography for the Management of Acute Pancreatitis in the United States

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S444-S445
Author(s):  
Zubair Khan ◽  
Nauman Siddiqui ◽  
Mohamad Moussa ◽  
Muhammad Ali Khan ◽  
Thomas Sodeman ◽  
...  
Keyword(s):  
United States ◽  
Acute Pancreatitis ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
The United States ◽  
Endoscopic Retrograde

scholarly journals Study protocol for a multicentre, randomised controlled trial of the external use of mirabilite to prevent pancreatitis in children after endoscopic retrograde cholangiopancreatography.

2021 ◽  
Author(s):  
Zhaohui Deng ◽  
Biao Gong ◽  
Kaihua Yang ◽  
Jingqing Zeng ◽  
Chan Lv ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Controlled Trial ◽  
Intestinal Barrier ◽  
Basic Research ◽  
Intestinal Barrier Function ◽  
Therapeutic Effects ◽  
Endoscopic Retrograde ◽  
Clinical Benefits ◽  
Randomised Controlled

Abstract Background Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP) in children. To date, there is no suitable medicine for post-ERCP pancreatitis prophylaxis in children and few study has prospectively evaluated an intervention to prevent post-ERCP pancreatitis in children. Mirabilite, a well-known traditional Chinese medicine(TCM) has good therapeutic effects on acute pancreatitis and no side effect for children by basic research and clinical studies. Our protocol is designed to assess the efficacy and safety of the external use of mirabilite to prevent post-ERCP pancreatitis in children. Methods/design: 520 patients planned for diagnostic and therapeutic ERCP will be enrolled according to the eligibility criteria‎. The patients will be randomly divided into two equal groups (Mirabilite and control, the external use of mirabilite in a bag on the projected abdominal area over the pancreas within 30 min before ERCP). The primary end point is incidence of post-ERCP pancreatitis. Secondary end points include abdominal pain scores, the levels of inflammatory markers [tissue necrosis factor (TNF)-α, IL-6, and IL-8] and intestinal barrier function markers (diamine oxidase, D-lactic acid, and endotoxin). Additionally, the side effects of topical mirabilite is investigated. Conclusion This trial would be the first experiment to determine mirabilite to prevent post-ERCP pancreatitis in children. Mirabilite maybe provide potential clinical benefits and a new avenue with tremendous potential for the future preventing of post-ERCP pancreatitis. Trial registration number: ChiCTR1900022642. Registered on 19 April 2019- Retrospectively registered, http://www.chictr.org.cn.

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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