Prognostic and severity value of the neutrophil-to-lymphocyte ratio in patients with acute diverticulitis: a systematic review with meta-analysis

Castro-Suárez P.; Montes-Baldarrago A.; Mora-Arévalo J.; Cabanillas-Lazo M. · Scandinavian Journal of Gastroenterology (2026) · DOI: 10.1080/00365521.2026.2731965

Resumen

Objective: This study evaluates the neutrophil-to-lymphocyte ratio (NLR) as a potential tool for assessing acute diverticulitis (AD) severity and prognosis. Methods: A systematic search was conducted in PubMed, Embase, Scopus, Web of Science and Google Scholar. A meta-analysis compared mean NLR values between complicated and non-complicated AD patients and those who underwent surgery versus non-surgical management. Results: Seventeen cohort studies were included. NLR >7.2 predicted mortality (sensitivity: 80%, specificity: 60%). The optimal NLR cutoff for predicting complicated AD was 4.862, with sensitivity of 74.17% (95% CI: 56.25%; 86.51%) and specificity of 68.41% (95% CI: 52.84%; 80.71%). The mean NLR was higher in the surgical group (MD: 2.85; 95% CI: −0.24; 5.95; I2: 86%). High NLR was associated with failure of non-surgical treatment (OR: 1.65; 95% CI: 0.47; 3.90). Conclusion: NLR may be a useful biomarker for AD severity and mortality risk. However, its relevance for predicting surgery need, treatment failure or recurrence is limited. Larger, prospective are needed to confirm its clinical utility.

Instituciones: Universidad Nacional Mayor de San Marcos; Universidad Científica del Sur