Introduction The neutrophil to lymphocyte ratio (NLR) has been proposed as a marker of systemic inflammation and stress. Recently it has been suggested that a raised NLR may be associated with severe cholecystitis and prolonged length of stay following cholecystectomy.¹We aimed to evaluate the use of NLR as a surrogate marker of severity of cholecystitis in predicting length of stay (LOS) for acute admissions.

Method A retrospective analysis of patients admitted with acute cholecystitis between January and October 2013. Acute cholecystitis was defined using the 2007 Tokyo classification. The NLR was calculated at admission as the absolute neutrophil count divided by the absolute lymphocyte count.

Results 51 patients with a mean age 58.9 years (14.1- 100.8 years) of which 31% (n = 16) were male. Ten patients (20%) had a cholecystectomy during admission. Length of stay ranged from 1 to 29 days (median 4 days).

A NLR >11 (n = 17, 33%) was associated with a longer LOS (median 9 days, 4–29 days) compared with an NLR <11 (median 4 days, 1–9 days). LOS was similar for males (median 4 days) compared with females (median 5 days). Those aged over 60 (n = 23, 45%) had a higher length of stay (median 7 days) compared with those under 60 (median 3 days).

Conclusion Preliminary results indicate that NLR seems to be predictive of length of stay in patients admitted with acute cholecystitis.

Disclosure of interest None Declared.

Reference

1. Lee SK, Lee SC, Park JW, Kim SJ. The utility of the preoperative neutrophil-to-lymphocyte ratio in predicting severe cholecystitis: a retrospective cohort study. BMC Surg. 2014 Nov 27;14:100