Clinical Report: Exploring the Relationship Between NLR and Acute Liver Injury

Overview

This study investigates the association between the neutrophil-to-lymphocyte ratio (NLR) and acute liver injury (ALI) in patients with acute pancreatitis. Findings indicate that NLR is an independent predictor of ALI, with a non-linear threshold effect identified at NLR = 2.92.

Background

Acute pancreatitis is a common emergency that can lead to serious complications, including acute liver injury, which increases mortality risk. Identifying patients at high risk for ALI is crucial for timely intervention. The neutrophil-to-lymphocyte ratio (NLR) serves as a simple inflammatory marker that may aid in early detection of ALI in acute pancreatitis.

Data Highlights

Key Findings

• ALI occurred in 37.7% of patients with acute pancreatitis.
• Each one-unit increase in NLR raised the risk of ALI by 11% (OR = 1.11).
• The highest quartile of NLR had a 5.42-fold increased risk of ALI compared to the lowest quartile.
• A non-linear threshold effect was identified at NLR = 2.92, with a sharp increase in risk below this value.
• NLR alone had an AUC of 0.688 for predicting ALI, with a sensitivity of 59.4% and specificity of 68.0%.
• Combining NLR with CRP and gallstones improved predictive accuracy (AUC = 0.756).

Clinical Implications

NLR can serve as an early warning signal for acute liver injury in patients with acute pancreatitis, particularly at a threshold of 2.92.

Conclusion

The study establishes NLR as an independent predictor of ALI in acute pancreatitis.

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