Simple number, complicated answers: neutrophil-to-lymphocyte ratio in acute pancreatitis – a systematic review and meta-analysis
- 1Surgical Center, Saint Paraskeva Medical Center, Lviv, Ukraine
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.
Related
- Prognostic value of the neutrophil-to-lymphocyte ratio in patients with colorectal cancer undergoing chemotherapy: a systematic review and meta-analysis
- Prognostic value of neutrophil-to-lymphocyte ratio in nasopharyngeal carcinoma: a systematic review and meta-analysis of 30 cohorts through June 30, 2026
- Beyond Prognosis: A Systematic Review of the Neutrophil-to-Lymphocyte Ratio as a Modifiable Cardiovascular Biomarker
- Associations of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios with amputation risk in patients with diabetic foot disease: a systematic review and meta-analysis
- The Prognostic Value of Baseline Neutrophil-to-Lymphocyte Ratio for Mortality in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis.
BibTeX
@article{chooklin2026simple,
title = {{Simple number, complicated answers: neutrophil-to-lymphocyte ratio in acute pancreatitis – a systematic review and meta-analysis}},
author = {S. M. Chooklin and S. S. Chuklin},
journal = {Український журнал клінічної хірургії},
year = {2026},
month = oct,
doi = {10.26779/2786-832x.2026.5.96},
url = {https://doi.org/10.26779/2786-832x.2026.5.96},
note = {CC BY},
}
RIS
TY - JOUR
TI - Simple number, complicated answers: neutrophil-to-lymphocyte ratio in acute pancreatitis – a systematic review and meta-analysis
AU - S. M. Chooklin
AU - S. S. Chuklin
PY - 2026
DA - 2026/10/23
JO - Український журнал клінічної хірургії
DO - 10.26779/2786-832x.2026.5.96
UR - https://doi.org/10.26779/2786-832x.2026.5.96
AB - 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.
SN - 2786-832X
SN - 2786-8311
ER -