Can the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and lymphocyte-monocyte ratio predict active bleeding in patients with upper gastrointestinal bleeding?

Objective: To investigate the relationship between upper gastrointestinal bleeding and neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), and examine whether they can be used as markers of inflammation. Methods: The retrospective single-center study included a total of 189 patients with upper gastrointestinal bleeding admitted to the tertiary emergency department between January 2018 and January 2019. Besides, 59 patients with similar demographic characteristics were selected as the control group. Besides, 42 patients with active bleeding and 147 patients without active bleeding were categorized into two groups according to their endoscopy reports. The NLR, PLR, LMR values, potential risk factors, and demographic characteristics were analyzed. Results: The mean NLR levels were found significantly higher in the patient group compared to the control group (P<0.001), whereas the mean LMR levels were significantly lower in the patient group (P<0.001). The mean NLR and PLR levels were significantly higher in patients with active bleeding compared to those without active bleeding (P<0.001), whereas the mean LMR levels were significantly lower (P<0.001) for patients with active bleeding. The optimal cut-off value of NLR was found 2.1 for predicting uppergastrointestinal bleeding, with a sensitivity of 80.2% and specificity of 78.9% (AUC: 0.840; P <0.001). Conclusions: NLR was determined to be a parameter that can be used as an indicator of active bleeding in patients with upper gastrointestinal bleeding.