Ratios of lymphocyte and neutrophil to lymphocyte as early predictors of the severity of acute pancreatitis at different age stratifications

Goal: To explore the values of lymphocyte ratio (LR) and neutrophil-to-lymphocyte ratio (NLR) in the early prediction of the severity of acute pancreatitis (AP) in patients of different ages. Background and Aims: LR and NLR, as early markers, can predict the severity of disease in patients with AP according to previous studies. However, all of the studies ignored the influence of the age factor. Study: The patients with AP from January 2012 to October 2017 were retrospectively analyzed. The patients were divided into mild acute pancreatitis (MAP) and severe acute pancreatitis (SAP) groups according to the latest Atlanta classification. In each group, the patients were further divided into the young and middle-aged group (ages ≤65), and the elderly group (ages >65). The neutrophil ratio (NR), LR and NLR were detected and collected within 24 h of disease onset. The relationship between various indicators and severity of AP was evaluated. Results: NLR (11.15±8.20 vs. 7.83±9.17 P < 0.001) significantly increased whereas LR (10.72±6.32 vs. 16.77±9.70 P < 0.001) significantly decreased in the SAP group compared to the MAP group. LR and NLR demonstrated a significant predictive value in the young- and middle-aged group. However, LR and NLR were not significant predictors in the elderly group. Conclusions: The LR reduction and NLR elevation in the early stages were closely related to the severity of AP. They were both important markers for predicting severity of AP, especially in the young and middle-aged patients.