Novel markers for mortality in patients with acute pancreatitis: NLR and PLR at the 48th hour

Aims: In recent years, simple, effective, and rapid laboratory markers have become important to predict acute pancreatitis prognosis. In this study, we aimed to demonstrate whether there was a difference in predicting AP-related mortality between current scores and indirect markers of systemic inflammation, namely, red cell distribution width (RDW), mean platelet volume (MPV), platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) obtained at the 48th hour.  Methods: We retrospectively reviewed files of AP patients admitted to Gastroenterology Department of two hospitals to include the acute phase reactant values of 667 patients obtained at the 48th hour. CRP0 indicates CRP value at presentation while CRP, RDW, MPV, NLR and PLR indicate values at the 48th hour. In all patients, Ranson score, Atlanta score, NLR and PLR values were calculated. Results: The patients were classified into 2 groups as survivors (n=641; 96.1%) and non-survivors (n=26; 3.9%). Both NLR and PLR were found to be significantly higher in the non-survivor group (P<0.001 and P=0.02). Both NLR and PLR were weakly and positively correlated to mortality.  Conclusion: Based on our results, MPV was not correlated with mortality, while RDW was weakly and positively correlated. However, we found that NLR and PLR values obtained at the 48th hour after presentation are effective parameters in predicting mortality in AP. These easily accessible and low-cost tests may be used for closer monitoring of these patients when necessary.