Comparison of neutrophil lymphocyte ratio and platelet lymphocyte ratio with Ranson criteria in acute biliary pancreatitis

Abstract

Aim: To evaluate the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in predicting the severity of acute biliary pancreatitis, in comparison with the Ranson scoring system.

Methods: A total of 353 patients diagnosed with acute biliary pancreatitis between January 2019 and December 2023 were retrospectively analyzed. Demographic data, laboratory findings, NLR, PLR, and Ranson scores were recorded. Patients were grouped as mild and severe according to clinical severity. The diagnostic performances of NLR, PLR, and Ranson score were assessed using receiver operating characteristic (ROC) curve analysis.

Results: NLR, PLR, and Ranson scores were significantly higher in the severe pancreatitis group compared to the mild group (p<0.001 for all). ROC analysis revealed that Ranson score had the highest area under the curve (AUC = 0.85), followed by NLR (AUC = 0.82) and PLR (AUC = 0.75). Sensitivity and specificity values were acceptable for all three parameters in distinguishing severe disease.

Conclusion: NLR and PLR are simple, cost-effective, and accessible inflammatory markers that may assist in predicting disease severity in acute biliary pancreatitis. Their diagnostic power is comparable to the Ranson scoring system and may support early risk stratification in clinical practice.