Neutrophil ratio predicts conservative treatment failure in cholecystitis

A higher neutrophil percentage-to-albumin ratio (npar) significantly predicts conservative treatment failure in acute cholecystitis, with an optimal cutoff of 21.5 showing 88.8% sensitivity and 84.8% specificity. In a cohort of 508 patients, 21.1% experienced failed treatment, leading to interventions like emergency surgery and drainage. Npar outperformed other inflammatory markers in predictive accuracy. These findings highlight a 48-hour critical window for monitoring patient outcomes in various clinical settings.