Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Acute cholecystitis(AC) is a frequent surgical emergency case. Preoperative inflammation and metabolic problems as well as an extended hospital stay are the outcomes of cholecystitis progression from basic to severe. The neutrophil to lymphocyte ratio (NLR) is a novel, low‐cost predictive biomarker for severe AC that can be used to stratify patients for the best course of treatment. The NLR appropriately reflects the underlying inflammatory reaction since inflammation causes the production of arachidonic acid metabolites as well as platelet‐activating agents, which leads to neutrophilia. Cortisol‐induced stress causes relative lymphopenia. To evaluate the utility of the NLR as a prognostic indicator in patients with cholecystitis and to observe the patterns of preoperative NLR in simple and severe cholecystitis. The present study was a cross‐sectional study was conducted at Sree Mookambika Institute of medical sciences from July 2023 to January 2024. In this study, 60 individuals with acute cholecystitis who were older than 18 were enrolled. The clinical characteristics and demographic data of the patients who were enrolled were gathered. Tokyo standards were used to categorize patients into groups with mild, moderate, or severe acute cholecystitis; the NLR was computed as the absolute neutrophil count divided by the absolute lymphocyte count. The information was gathered and input into SPSS Statistics version 22. Student's t‐test was used to assess the variation between the severe and non‐severe AC groups in order to analyze continuous variables. The relationship between the category variables was assessed using the chi‐square test. P‐values less than 0.05 were regarded as significant. According to the Tokyo guidelines classification of AC, 34 (56.67%) had mild cholecystitis, 16 (26.67%) had intermediate cholecystitis 10 (16.67%) had severe AC. The mean total WBC count, NLR, HbA1c, CRP and total bilirubin level all rose (p<0.05) in proportion to the severity of cholecystitis. The majority of patients with severe cholecystitis had pericholecystic fluid accumulation and fat stranding. Compared to the other two subgroups, individuals with severe cholecystitis had a higher mean hospital stay (p = 0.003). ICU stays were required by patients with severe cholecystitis (p<0.001). Patients with severe cholecystitis had mortality rate (p<0.001). In patients with AC, NLR has shown to be a prognostic marker for assessing the severity of the disease, which will aid in effective care and improve patient prognosis.
How to cite this article:
Pallamala Lasya and G. Divya. Neutrophil‐to‐Lymphocyte Ratio as A Predictor for Severe Acute Cholecystitis.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.7.416.420
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.7.416.420