Association between neutrophil-to-lymphocyte ratio in the first seven days of sepsis and mortality

Lorente, Leonardo; Martı́n, Marı́a; Ortiz-López, Raquel; Álvarez-Castillo, Andrea; Ruiz, Candelaria; Uribe, Luis; González-Rivero, Agustín F.; Pérez-Cejas, Antonia; Jiménez, Alejandro

doi:10.1016/j.eimc.2020.11.004

Cited by 10 publications

(15 citation statements)

References 18 publications

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“…CRP is an acute phase reaction protein, mainly synthesized and released by the liver, which slowly increases to hundreds or thousands of times its normal level after 8–12 h when the organism is invaded by pathogenic microorganisms or stimulated by inflammation, and gradually returns to normal level after reasonable treatment, which can reflect the severity of infection to some extent ( 23 ). As for the relationship between NLR and sepsis, some studies ( 24 ) have suggested that leukocytosis and lymphopenia are a distinctive feature of severe sepsis, and some foreign scholars ( 25 , 26 ) have suggested that NLR can be used as a marker for the early detection and diagnosis of sepsis and that NLR is more effective than conventional inflammatory biomarkers. This study focused on analyzing the differences in the levels of PCT, CRP, and NLR in patients with bloodstream infection sepsis and correlating them with the concurrently rated APACHEII to provide a reference basis for early clinical assessment of the severity of sepsis patients and their prognosis.…”

Section: Discussionmentioning

confidence: 99%

Value of CRP, PCT, and NLR in Prediction of Severity and Prognosis of Patients With Bloodstream Infections and Sepsis

Liang

2022

Front. Surg.

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ObjectiveTo investigate the value of C-reactive protein (CRP), procalcitonin (PCT), and neutrophil to lymphocyte ratio (NLR) in assessing the severity of disease in patients with bloodstream infection and sepsis, and to analyze the relationship between the levels of three inflammatory factors and the prognosis of patients.MethodsThe clinical data of 146 patients with bloodstream infection and sepsis admitted to our intensive care unit (ICU) from October 2016 to May 2020 were retrospectively analyzed. The differences in the levels of inflammatory indicators such as CRP, PCT, and NLR within 24 h in patients with bloodstream infection sepsis with different conditions (critical group, non-critical group) and the correlation between these factors and the condition (acute physiology and chronic health evaluation II, APACHE II score) were analyzed. In addition, the prognosis of all patients within 28 days was counted, and the patients were divided into death and survival groups according to their mortality, and the risk factors affecting their death were analyzed by logistic regression, and the receiver operating characteristic (ROC) curve was used to analyze the value of the relevant indicators in assessing the prognosis of patients.ResultsThe levels of NLR, CRP, PCT, total bilirubin (TBIL), glutamic oxaloacetic transaminase (AST), and serum creatinine (Scr) were significantly higher in the critically ill group than in the non-critically ill group, where correlation analysis revealed a positive correlation between CRP, PCT, and NLR and APACHE II scores (P < 0.05). Univariate logistic regression analysis revealed that CRP, PCT, NLR, and APACHE II scores were associated with patient prognosis (P < 0.05). Multi-factor logistic regression analysis found that PCT, NLR, and APACHE II scores were independent risk factors for patient mortality within 28 days (P < 0.05). ROC curve analysis found that PCT and NLR both had an AUC area > 0.7 in predicting patient death within 28 days (P < 0.05).ConclusionInflammatory factors such as NLR, CRP, and PCT have important clinical applications in the assessment of the extent of disease and prognosis of patients with bloodstream infection and sepsis.

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Section: Discussionmentioning

confidence: 99%

Value of CRP, PCT, and NLR in Prediction of Severity and Prognosis of Patients With Bloodstream Infections and Sepsis

Liang

2022

Front. Surg.

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“…Lorente et al [11] found that the NLR within 7 days after the diagnosis of sepsis was associated with the severity and mortality of sepsis. Jie C et al [12] studied 226 sepsis patients and found that the AUC of NLR in predicting the 28 days death of sepsis patients was 0.642[95%CI (0.556, 0.728)].…”

Section: Resultsmentioning

confidence: 99%

The Value of NLR Combined SOFA in Assessing the Prognosis of Sepsis Patients

Wang

Wei

et al. 2021

Preprint

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Background: In order to evaluate the risk factors and its assessment values in patients with sepsis, and to explore a method to improve the prognosis prediction efficiency of patients with sepsis.Methods: Patients with sepsis admitted to Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University from January 2020 to December 2020 were enrolled, and they were divided into survival group and death group according to the prognosis at 28 days. Demographic data of patients and laboratory values at admission were collected. In terms of the first time data within 24h of patients admitted to hospital, the sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score were calculated, and compared the difference between the two groups, the logistic regression was used to analysis the risk factors for death within 28 days, as well as the calculated combined predictor of SOFA and neutrophil to lymphocyte ratio (NLR). Predicted values of various indicators for 28 days’ mortality in sepsis patients were analyzed by receiver operating characteristic (ROC) curve.Results: 302 patients in total were included in this study, including 238 patients in survival group and 64 patients in death group. The age (78.36±9.8 years old vs. 71.6±14.1 years old), procalcitonin (PCT) (1.00 ng/ml vs. 0.05 ng/ml), C-reactive protein (CRP) (93 mg/l vs 14 mg/l), lactic acid (Lac) (1.20 mmol/l vs. 2.20 mmol/l), NLR (11.7 vs. 6.20), SOFA score (8 vs. 4) and APACHE Ⅱ score(20.5 vs. 11.0) of death group were significantly higher than those of survival group (all P<0.001). Age (OR=1.046, 95%CI 1.020-1.074, P=0.001), PCT (OR=1.115, 95%CI 1.055-1.177, P<0.001), CRP (OR=1.016, 95%CI 1.011-1.021, P<0.001), Lac (OR=1.887, 95%CI 1.518-2.346, P<0.001), NLR (OR=1.038, 95%CI 1.016-1.060, P=0.001), APACHE Ⅱ score (OR=1.231, 95%CI 1.166-1.300, P<0.001), SOFA score (OR=1.499, 95%CI1.344-1.671, P<0.001), NLR combined SOFA (SOFA+NLR×0.085) (OR=1.492, 95%CI1.341-1.660, P<0.001) were risk factors of 28 days’ mortality in sepsis patients, and the area under the curve (AUC) of APACHE Ⅱ, NLR combined SOFA were 0.853 and 0.855, higher than Lac (0.767, P<0.05), CRP (0.746, P<0.05) and PCT (0.761, P<0.05), the AUC of APACHE Ⅱ was similar with NLR combine SOFA (P>0.05). The sensitivity and specificity of APACHE Ⅱ and NLR combined SOFA to predict the 28 days’ prognosis of sepsis patients were better than the other indicators. Conclusion: NLR combined SOFA was a risk factor for the death of sepsis patients, and its predictive efficacy was similar with that of APACHE Ⅱ score, which is superior to other predictive indexes.

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“…Zahorec et al 11 conducted a prospective study of 90 ICU patients and found that NLR predicted the severity and prognosis of sepsis patients. Lorente et al 12 found that NLR within 7 days after a diagnosis of sepsis was associated with the severity and mortality of sepsis. Chen et al 13 studied 226 sepsis patients and found that the AUC of NLR in predicting the 28-day death rate in sepsis patients was 0.642 (95% CI 0.556–0.728).…”

Section: Discussionmentioning

confidence: 99%

Value of Neutrophil:Lymphocyte Ratio Combined with Sequential Organ Failure Assessment Score in Assessing the Prognosis of Sepsis Patients

Li¹,

Wang²,

Wei³

et al. 2022

IJGM

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Background We aimed to evaluate risk factors and assessment values in patients with sepsis and to explore a method of improving prognosis-prediction efficiency for patients with sepsis. Methods Patients with sepsis admitted to the Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University from January 2020 to December 2020 were enrolled. Demographic data of patients and laboratory values at admission were collected. Sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation II (APACHE II) scores were calculated within 24 hours of admission and logistic regression used to analyze risk factors of death within 28 days, as well as the combined predictor of SOFA score and neutrophil:lymphocyte ratio (NLR). Predicted values of various indicators for 28-day mortality in sepsis patients were analyzed using receiver-operating characteristic curves. Results A total of 302 patients were included in this study, of whom 64 (21.2%) died. Age, Pct, CRP, Lac, NLR (OR 1.054, 95% CI 1.032–1.076), SOFA score (OR 1.434, 95% CI 1.293–1.591), APACHE II score (OR 1.231, 95% CI 1.166–1.300), and NLR combined with SOFA (SOFA+NLR×0.149: OR 1.455, 95% CI 1.318–1.605) were risk factors of 28-day mortality in sepsis patients, and areas under the curve of NLR combined with SOFA score were significantly higher than each of NLR and SOFA scores and similar to APACHE II scores. The sensitivity and specificity of NLR combined with SOFA and APACHE II scores to predict the 28-day prognosis of sepsis patients were better than the other indicators. Conclusion NLR combined with SOFA was a risk factor of the death of sepsis patients and its predictive efficacy similar to that of the APACHE II score, which is superior to other predictive indices.

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Association between neutrophil-to-lymphocyte ratio in the first seven days of sepsis and mortality

Cited by 10 publications

References 18 publications

Value of CRP, PCT, and NLR in Prediction of Severity and Prognosis of Patients With Bloodstream Infections and Sepsis

Value of CRP, PCT, and NLR in Prediction of Severity and Prognosis of Patients With Bloodstream Infections and Sepsis

The Value of NLR Combined SOFA in Assessing the Prognosis of Sepsis Patients

Value of Neutrophil:Lymphocyte Ratio Combined with Sequential Organ Failure Assessment Score in Assessing the Prognosis of Sepsis Patients

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