Simple number, complicated answers: neutrophil-to-lymphocyte ratio in acute pancreatitis – a systematic review and meta-analysis
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Objective. To evaluate the clinical utility of the neutrophil-to-lymphocyte ratio (NLR) for early prediction of severe acute pancreatitis (SAP) across admission, 24-hour, and 48-hour windows.Methods. Systematic review with meta-analytic synthesis of studies measuring NLR at admission and during the first two days, using random-effects and bivariate diagnostic-accuracy models.Results. Elevated admission NLR consistently tracked with subsequent severe disease and performed as well as – or better than – baseline laboratory indicators in emergency settings. Discrimination at presentation supported reliable early risk stratification, while day-1/day-2 trajectories maintained or enhanced sensitivity, enabling practical re-triage after initial management. Pooled accuracy estimates and hierarchical performance curves demonstrated good ability of NLR to distinguish severe from non-severe courses across cohorts and etiologic subgroups.Conclusions. NLR is a simple, reproducible tool for early prediction of the severe course of acute pancreatitis; time-specific measurements with local threshold calibration and integration into standard clinical scores are recommended.
Authors: S. M. Chooklin, S. S. Chuklin
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223307600