Demographic and Clinical Characteristics in Patients with Elevated Neutrophil-Lymphocyte Ratio Undergoing Cholecystectomy

Introduction: Cholecystectomy, the surgical removal of the gallbladder, is a common procedure performed to address gallbladder-related conditions, primarily gallstones and cholecystitis. This study aimed to evaluate the demographic and clinical characteristics of patients with elevated neutrophil-lymphocyte ratio undergoing cholecystectomy. Methods: This prospective observational study was conducted at the various surgical units of the inpatient Department of Surgery, Dhaka Medical College Hospital, Dhaka, from July 2018 to June 2019. Patients with cholecystitis attending in the outdoor or emergency, admitted with cholecystitis in Dhaka Medical College Hospital, Dhaka were considered as the study population. A total of 50 patients were selected as study subjects by purposive sampling technique. Statistical Package for Social Science (SPSS) version 21 for Windows was used to analyze the data. A p-value < 0.05 was considered to be significant. Result: Among 50 cholecystectomy patients, 68% were admitted as outpatients, and 32% via the emergency department. The predominant symptom was abdominal pain (92%), and the mean serum leukocyte count was significantly higher in the elevated NLR (≥3) group (13500/mm³ vs. 6200/mm³, p <0.004). Eighty percent had gallbladder calculus, with 82% diagnosed with simple cholecystitis. Most procedures (78%) were laparoscopic, and 72% did not require drains. The mean postoperative hospital stay was 4 days, longer for the elevated NLR group (median 6 days vs. 4 days, p <0.002). Complications occurred in 30% of patients, with a higher incidence in the elevated NLR group. Conclusion: The findings suggest that an elevated neutrophil-lymphocyte ratio (NLR) is linked to important clinical characteristics and outcomes, especially in older adults and males. Patients with higher NLR exhibited increased rates of laparoscopic conversion, longer operative times, and extended postoperative hospital stays. Additionally, they were more likely to need ...