Usage of the Ranson criteria and neutrophil-lymphocyte ratio measured on presentation to the emergency department in the prediction of mortality in acute pancreatitis

Abstract

The aim of this study is to examine the usefulness of the Ranson criteria and neutrophil-to-lymphocyte ratio (NLR) on admission to the emergency department (ED) in regard to the prediction of mortality for patients diagnosed with acute pancreatitis (AP) and compare the predictive ability of these two parameters. All patients information aged over 18 years who presented to ED and were diagnosed with AP in the three-year study period were analyzed retrospectively. The data were provided from the electronic-based hospital information system. To assess the cut-off value of each variable in discriminating between the survivor and non-survivor groups, the receiver operating characteristic (ROC) analysis and the area under the curve (AUC) were used. This study included 318 adult patients (47.5% male) with a mean age of 58.6 ± 17.6 years. As a result of the ROC analysis of the Ranson criteria for mortality prediction, the AUC value was calculated as 0.65 (95% confidence interval (CI): 0.57–0.70), the Youden index as 0.28, and the p value as 0.002, while the ROC analysis of NLR revealed an AUC value of 0.58 (95% CI: 0.52–0.64), Youden index of 0.29, and p value of 0.08. The Ranson criteria can provide a clinical guide in the prediction of the prognosis of AP patients. However, according to the results of this study, NLR recorded at the time of admission was found to be ineffective on predicting the prognosis of AP patients.