SynthesisLangenbeck's archives of surgery2022
The predictive significance of neutrophil-to-lymphocyte ratio in cholecystitis: a systematic review and meta-analysis.
Synthesis in Langenbeck's archives of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 14 citations in OpenAlex.
- Comparative performance among inflammatory biomarkers for pre-operative prediction of gangrenous cholecystitis.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Observational
- Article
- The Diagnostic Accuracy of Neutrophil-to-Lymphocyte Ratio (NLR) Compared to C-Reactive Protein (CRP) in Patients with Acute Cholecystitis: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2026Review
- Comparative Early Postoperative Outcomes in Acute Calculous vs. Acute Acalculous Cholecystitis: A Retrospective Analysis.Medicina (Kaunas, Lithuania) · 2026Article
- Preoperative Inflammatory Markers (NLR, MLR, PLR) in Evaluating Acute Cholecystitis Severity and Operative Difficulty.Life (Basel, Switzerland) · 2026Article
- Prognostic role of systemic inflammatory indices in predicting the severity of acute calculous cholecystitis.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Article
- Development and external validation of a machine learning model for predicting gangrenous cholecystitis.Frontiers in medicine · 2026Article
- The association between inflammatory biomarkers and gallstones in Americans under 50 years old.BMC gastroenterology · 2025Article
- Neutrophil percentage-to-albumin ratio as a predictor of conservative treatment failure in acute cholecystitis: a retrospective cohort study.BMC surgery · 2025Article
- Inflammatory burden index (IBI) and body roundness index (BRI) in gallstone risk prediction: insights from NHANES 2017-2020.Lipids in health and disease · 2025Article
- Predicting severity of inpatient acute cholangitis: combined neutrophil-to-lymphocyte ratio and prognostic nutritional index.BMC gastroenterology · 2024Article
- Association between Neutrophil-to-high-density lipoprotein-cholesterol ratio and gallstones: insights from the national health and nutrition examination survey (2017-2020).Lipids in health and disease · 2024Article
- The role of biomarkers in predicting perforated cholecystitis cases: Can the c-reactive protein albumin ratio be a guide?Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2024Article
- The Role of Different Systemic Inflammatory Indexes Derived from Complete Blood Count in Differentiating Acute from Chronic Calculus Cholecystitis and Predicting Its Severity.Journal of inflammation research · 2024Article
- Efficacy of blood parameters as indicators of the need for overdue urgent cholecystectomy in elderly patients with acute cholecystitis.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2023Article
- Clinical Significance of the Neutrophil-Lymphocyte Ratio as an Early Predictive Marker for Adverse Outcomes in Patients with Acute Cholangitis.Medicina (Kaunas, Lithuania) · 2022Article
- A Retrospective Study on Use of Neutrophil-Lymphocyte Ratio as a Prognostic Measurement to Assess Acute Diverticulitis.ANZ journal of surgeryObservational
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this review was to examine whether neutrophil-to-lymphocyte ratio (NLR) can predict the presence of cholecystitis and distinguish between simple and severe cholecystitis.
methodsA systematic literature search was performed. Risk of bias was assessed using the Newcastle-Ottawa Scale. Random effects model was used to calculate mean difference (MD) in two situations: (a) no cholecystitis versus cholecystitis and (b) simple versus severe cholecystitis. Receiver operating characteristic (ROC) curve analysis was performed to determine cut-off values of NLR for the above situations.
resultsTen retrospective studies comprising of 2827 patients were included. Three hundred twenty-seven had no cholecystitis, 2100 had simple cholecystitis and the remaining 400 had severe cholecystitis. NLR was significantly higher in acute cholecystitis compared to "no cholecystitis" (MD = 8.05 (95% CI 7.71-8.38), p < 0.01) and in severe cholecystitis when compared with simple cholecystitis (MD = 3.14 (95% CI 1.26-5.02), p < 0.01). For patients with cholecystitis compared to those without cholecystitis, an NLR cut-off value of 2.98 was identified (AUC = 0.90). Logistic regression analysis confirmed an NLR > 2.9 was an independent predictor of cholecystitis (OR 36.0, p = 0.006). In simple versus severe cholecystitis, an NLR cut-off value of 8.5 was identified (AUC = 0.73). Binary logistic regression analysis suggested an NLR > 8.5 was not an independent predictor of severe cholecystitis (OR 6.5 p = 0.090).
conclusionNLR is significantly higher in patients with cholecystitis of any severity compared to patients without cholecystitis. Moreover, NLR can predict acute cholecystitis. However, NLR cannot predict the severity of disease due to inadequately powered studies. Future research is required.
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