Predicting severity of inpatient acute cholangitis: combined neutrophil-to-lymphocyte ratio and prognostic nutritional index

The indicators for rapid assessment of the severity of acute cholangitis remain highly debated. Therefore, this study aimed to evaluate the efficacy of various inflammatory and immune-nutritional markers in predicting the severity of acute cholangitis. The prognostic roles of the following markers were investigated: Systemic Immune-Inflammatory Index (SII), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Albumin (Alb), and Prognostic Nutritional Index (PNI). A total of 139 patients with acute cholangitis were included in the study. The inflammatory and immune-nutritional markers with better predictive efficacy were selected to construct a combined predictive score. According to the survival ROC curve analysis, the combined NLR and PNI score, termed PNS, demonstrated the best prognostic performance with an AUC of 0.853. Multivariable survival analysis identified the following independent prognostic factors: PNS (p = 0.010) and Prothrombin Time (PT) (p = 0.003). The results indicate that PNS = 2 is associated with a higher incidence of severe cholangitis.