Role of Neutrophil–Lymphocyte Ratio in Predicting Severity and Outcome of Acute Pancreatitis

Background: Acute pancreatitis is an inflammatory condition with variable clinical presentation ranging from mild self-limiting disease to severe life-threatening illness associated with organ failure and mortality. Early prediction of disease severity is essential for prompt management. The Neutrophil–Lymphocyte Ratio (NLR) has emerged as a simple and cost-effective inflammatory marker. The aim is in order to assess the usefulness of Neutrophil–Lymphocyte Ratio in the prediction of severity and clinical outcome in acute pancreatitis. Material and Methods: The SSIMS & RC Department of General Surgery conducted a clinical study of prospective research for 6 months from March 2025 till September 2025. 18 patients were diagnosed with acute pancreatitis and included. On admission (Day 0), at 24 hours (Day 1) and at 48 hours (Day 2), neutrophil and lymphocyte counts were obtained and NLR was calculated. Severity was graded by parameters of Revised Atlanta Classification. Statistical analysis was carried out by Independent sample t test and p value of <0.05 was considered as statistically significant value. Results: There were 18 patients, 15 of whom (83.3%) suffered from mild pancreatitis and 3 (16.7%) from severe pancreatitis. The NLR levels of severe pancreatitis patients were significantly higher than those of mild pancreatitis patients at each of the time points. Mean NLR on Day 0 was 15.8 ± 2.5 in severe pancreatitis compared to 5.1 ± 1.2 in mild pancreatitis. In mild cases, NLRs gradually decreased while more severe cases showed increasing NLRs. There was significant correlation between NLR and organ failure, local complications, and mortality (p<0.05). Conclusion: Neutroph–Lymphocyte Ratio is simple, inexpensive and reliable biomarker for the prediction of the severity and outcome of acute pancreatitis. Early identification of high-risk patients using serial monitoring of NLR and management of NLR. Corresponding to the equality, the keywords are Acute pancreatitis, Neutrophil–Lymphocyte Ratio, NLR, Severity assessment, Inflammatory markers.

Keywords: Acute pancreatitis, Neutrophil-to-Lymphocyte Ratio, NLR, Disease severity, Revised Atlanta Classification.