Value of Neutrophil to Lymphocyte Ratio in Prognosis of Elderly Patients with Community Acquired Pneumonia Compared to CRP Level

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Gehan M Elassal ◽  
Mohamed A Elsayed ◽  
Amal M Shehata
Keyword(s):  
Elderly Patients ◽  
Severe Infection ◽  
Community Acquired Pneumonia ◽  
Health Care Facilities ◽  
University Hospitals ◽  
Additional Advantage ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Hospitalization Period ◽  
Significant Difference

Abstract Background Community-acquired pneumonia (CAP) is a common, potentially fatal disease despite advances in both diagnosis and treatment. Community-acquired pneumonia is the most common type of pneumonia. It occurs outside of hospitals or other health care facilities. Community acquired pneumonia (CAP) is a frequent and severe infection associated with a high mortality. Objectives This work aims to evaluate the role of neutrophil/lymphocyte ratio in prognosis of elderly patients with community acquired pneumonia compared to CRP level. Patients and Methods This prospective study was conducted upon 30 elderly patients in chest department at Ain shams University hospitals with community acquired pneumonia. All patients were diagnosed as having CAP by presence of new infiltrates in chest radiography associated with clinical picture. Clinical examination, traditional tests such as Confusion, Urea, Respiratory rate, Blood pressure, aged 65 and older (CURB-65), CRP level and NLR were evaluated at admission and after two weeks of admission. The predictive value for 30-day mortality of traditional tests and NLR were compared. Results The present study found that mean age of the studied cases was 72.9 ± 5.14 years old, 20 (66.7%) of patients were males while 10 (33.3%) were females. All patients had co-morbidities with diabetes mellitus and renal impairment the most common by percentage of 36.7%. There was highly significant correlation between neutrophil/lymphocyte count ratio (NLCR), neutrophil count and lymphocytic count and the outcome of CAP patients (p = 0.000, 0.004, 0.000 respectively) compared to other inflammatory biomarkers like WBC count (p = 0.02) and CRP (p = 0.521) and CURB-65 score (p = 0.074). This study showed that no deaths occurred in patients with NLR below 10, mortality was 8.3% in patients with NLR between 10 and 20 and 91.7% in patients with a NLR above 20. NLCR remain high with no significant difference in follow up labs among patients who died. Conclusion NLR showed emerging prognostic value in predicting outcome and 30day mortality rate in community acquired pneumonia. Unlike many other inflammatory markers and bioassays, NLR is an inexpensive, easy to handle, cost effective and readily available marker that is obtained from basic blood count providing an additional advantage in predicting hospitalization period and mortality.

scholarly journals ANGKA BANDING NETROFIL/LIMFOSIT DI POPULASI DEWASA MUDA

2018 ◽  
Vol 22 (2) ◽  
pp. 105
Author(s):  
Arie Yanti ◽  
Uleng Bahrun ◽  
Mansyur Arif
Keyword(s):  
Adult Population ◽  
Reference Value ◽  
Severe Infection ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical Checkup ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference

Previous studies have shown that neutrophil/lymphocyte ratio in bacteremia is higher than nonbacteremia, therefore it could beused as a marker to distinguish both conditions in patients with sepsis .Another study on oncology patients in ICU showed a correlationbetween the severity of clinical course and the increase of neutrophil/lymphocyte ratio. In physiological condition, neutrophil/lymphocyteratio <5, while in pathological conditions (severe infection or systemic inflammation) neutrophil/lymphocyte ratio increases >6.Neutrophil/lymphocyte ratio is a sensitive, fast, cost effective and applicable laboratory test for routine use, therefore this test result canbe used as the parameter to assess clinical condition of patients. However, a reference value of neutrophil/lymphocyte ratio has neverbeen defined, especially in Makassar City, South Sulawesi Province. The aim of this study was to know the neutrophil/lymphocyte ratioin a healthy young adult population. A cross sectional study was conducted from March to April 2014, involving residents (specialisticcandidates in Medical Faculty, Hasanuddin University, who underwwent medical checkup and voluntarily joined this study. Samplesconsisted of 198 persons who fulfilled the inclusion criteria with an age range between 24-40 years old, comprising 84 males (42.42%)and 114 females (57.58%). The neutrophil/lymphocyte ratio for all samples was 1.95 (1.15-4.74). Mann Whitney test showed thatthere was no significant difference of neutrophil/lymphocyte ratio between males and females, 1.88 (1.25-4.74) vs 1.95 (1.15-4.12),p=0.65 and neither between the age group 21-30 years old and 31-40 years old, 1.95 (1.21-4.74) vs 1.94 (1.15-4.09), p=0.82.

scholarly journals The prognostic and diagnostic significance of the neutrophil-to-lymphocyte ratio in hepatocellular carcinoma: a prospective controlled study

2021 ◽  
Author(s):  
Philip J. Johnson ◽  
Sofi Dhanaraj ◽  
Sarah Berhane ◽  
Laura Bonnett ◽  
Yuk Ting Ma
Keyword(s):  
Hepatocellular Carcinoma ◽  
Regression Analysis ◽  
Prognostic Factor ◽  
Cox Regression ◽  
Prognostic Models ◽  
Controlled Study ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference

Abstract Background The neutrophil–lymphocyte ratio (NLR), a presumed measure of the balance between neutrophil-associated pro-tumour inflammation and lymphocyte-dependent antitumour immune function, has been suggested as a prognostic factor for several cancers, including hepatocellular carcinoma (HCC). Methods In this study, a prospectively accrued cohort of 781 patients (493 HCC and 288 chronic liver disease (CLD) without HCC) were followed-up for more than 6 years. NLR levels between HCC and CLD patients were compared, and the effect of baseline NLR on overall survival amongst HCC patients was assessed via multivariable Cox regression analysis. Results On entry into the study (‘baseline’), there was no clinically significant difference in the NLR values between CLD and HCC patients. Amongst HCC patients, NLR levels closest to last visit/death were significantly higher compared to baseline. Multivariable Cox regression analysis showed that NLR was an independent prognostic factor, even after adjustment for the HCC stage. Conclusion NLR is a significant independent factor influencing survival in HCC patients, hence offering an additional dimension in prognostic models.

Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy cohort

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Esin Merve Erol Koç ◽  
Rahime Bedir Fındık ◽  
Hatice Akkaya ◽  
Işılay Karadağ ◽  
Eda Özden Tokalıoğlu ◽  
...  
Keyword(s):  
Complete Blood Count ◽  
Perinatal Outcomes ◽  
Control Group ◽  
Strong Positive Correlation ◽  
Monocyte Count ◽  
Distribution Width ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference ◽  
Adverse Perinatal Outcomes

AbstractObjectivesTo evaluate the relationship between Coronavirus Disease 2019 (COVID-19) in pregnancy and adverse perinatal outcomes. The secondary aim is to analyze the diagnostic value of hematologic parameters in COVID-19 complicated pregnancies.MethodsThe current study is conducted in a high volume tertiary obstetrics center burdened by COVID-19 pandemics, in Turkey. In this cohort study, perinatal outcomes and complete blood count indices performed at the time of admission of 39 pregnancies (Study group) complicated by COVID-19 were compared with 69 uncomplicated pregnancies (Control group).ResultsThere was no significant difference between the obstetric and neonatal outcomes of pregnancies with COVID-19 compared to data of healthy pregnancies, except the increased C-section rate (p=0.026). Monocyte count, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) were significantly increased (p<0.0001, p=0.009, p=0.043, p<0.0001, respectively) whereas the MPV and plateletcrit were significantly decreased (p=0.001, p=0.008) in pregnants with COVID-19. ROC analysis revealed that the optimal cut-off value for MLR was 0.354 which indicated 96.7% specificity and 59.5% sensitivity in diagnosis of pregnant women with COVID-19. A strong positive correlation was found between the MLR and the presence of cough symptom (r=41.4, p=<0.0001).ConclusionsThe study revealed that, pregnancies complicated by COVID-19 is not related with adverse perinatal outcomes. MLR may serve as a supportive diagnostic parameter together with the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in assessment of COVID-19 in pregnant cohort.

scholarly journals Assessment of the hemogram parameters in patients with paroxysmal supraventricular tachycardia: a retrospective study

2020 ◽  
Vol 66 (10) ◽  
pp. 1371-1375
Author(s):  
Mehmet Cosgun ◽  
Yilmaz Gunes ◽  
Isa Sincer ◽  
Asli Kurtar Mansiroglu
Keyword(s):  
Retrospective Study ◽  
Supraventricular Tachycardia ◽  
University Hospital ◽  
Control Group ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Monocyte Count ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Markers Of Inflammation ◽  
Significant Difference

SUMMARY OBJECTIVE: Inflammation has been suggested as a potential mechanism in the pathogenesis of arrhythmia. Hemogram parameters such as monocyte count to high-density lipoprotein cholesterol ratio (MHR), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) have been considered to be markers of inflammation and new cardiovascular risk predictors. This retrospective study aimed to investigate the relationship between MHR, NLR, and MLR in patients with paroxysmal supraventricular tachycardia (PSVT). METHODS: A retrospective study conducted at a university hospital in Bolu, Turkey, between 2017 and 2019. Our study included 196 patients who underwent electrophysiological study (EPS) due to palpitation or documented PSVT on electrocardiography (ECG). Patients having documented atrioventricular nodal re-entrant tachycardia (AVNRT) on ECG or inducible AVNRT on EPS were included in the PSVT group (n=130), and patients with palpitation but without inducible arrhythmia on EPS (n=66) were included in the control group. Routine biochemical and hemogram tests were performed before the EPS procedure. RESULTS: When hemogram parameters were compared, there was no statistically significant difference in MHR values [0.010 (0.001-0.030) vs 0.010 (0.001-0.020) p =0.67]. Additionally, both NLR [2.21(0.74-11.36) vs 1.98(0.72-24.87) p=0.13] and MLR [0.25 (0.03-1.05) vs 0.24(0.07-1.39) p=0.41] were not statistically significant between the two groups. CONCLUSION: There is no significant difference in PSVT patients regarding hemogram parameters including white blood cell subtypes, MLR, NLR, and MHR. Therefore the evaluation of hemogram parameters may not be clinically relevant for PSVT patients.

scholarly journals Serum S100A8 as an early diagnostic biomarker in patients with community-acquired pneumonia

2020 ◽  
Author(s):  
Ling Zheng ◽  
Jun Fei ◽  
Zheng Xu ◽  
Chun-Mei Feng ◽  
Se-Ruo Li ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Inflammatory Cytokines ◽  
Demographic Data ◽  
A549 Cells ◽  
Community Acquired Pneumonia ◽  
Diagnostic Biomarker ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Severity Scores

Abstract Background and Objectives Limited studies suggested that calprotectin may take part in the pathophysiology of community-acquired pneumonia (CAP). Nevertheless, there is no clinical study to analyze the role of S100A8 in CAP patients. The objective of this study was to analyze the association of serum S100A8 with the severity of CAP based on a cross-sectional study. Methods Entire 200 CAP patients and 100 normal subjects were recruited. Demographic data, clinical information and serum were collected on admission. Serum S100A8 and inflammatory cytokines were detected. Results Serum S100A8 was increased in CAP patients on admission. Serum S100A8 was gradually increased in parallel with the CAP severity scores. Serum S100A8 was positively correlated with CAP severity scores (CURB-65, CRB-65, PSI, CURXO and SMART-COP), blood routine parameters (WBC, neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio) and inflammatory cytokines (TNFα, IL-1β and CRP). Furtherly, univariate and multivariate logistical regression analysis revealed that there was a positive association between serum S100A8 with CRB-65, PSI and CURXO. Moreover, the predictive capacity of serum S100A8 was performed by receiver operating characteristic area under the curve (AUC) analysis. The AUCs of S100A8 for CAP and CAP severity were 0.855 and 0.893, respectively. Mechanistic analysis found that S100A8 knockdown alleviated streptococcus pneumoniae-evoked inflammatory cytokines in A549 cells. Conclusion Serum S100A8 on admission was positively associated with the severity of CAP. S100A8 knockdown alleviates streptococcus pneumoniae- evoked inflammatory cytokines in A549 cells, indicating that S100A8 may exert an important role in the pathophysiology of CAP and be an early serum diagnostic biomarker for CAP.

scholarly journals ROLE OF HEMATOLOGICAL PARAMETERS IN EARLY DIAGNOSIS OF COVID-19 IN A TERTIARY CARE CENTRE

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Angira Saha ◽  
Sakar Saxena ◽  
Romi Srivastava ◽  
Sanjeev Narang
Keyword(s):  
Early Diagnosis ◽  
Hematological Parameters ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Significant Difference

Aim: To evaluate the role of biomarkers from blood samples of COVID-19 patients admitted in Index Medical College Hospital & R.C. Material & Methods: Hematological parameters such as Neutrophil lymphocyte ratio (NLR), Platelet lymphocyte ratio (PLR) & Systemic Inflammatory Index (SII) were studied in RT-PCR positive patients to evaluate the utility of these parameters for early diagnosis of COVID-19. Results: The study showed that there was statistically significant difference in test groups in reference to Neutrophil lymphocyte ratio (NLR) & SII values (p<0.05). But no statistically significant difference was observed between test groups in reference to Platelet lymphocyte ratio (PLR) values (p>0.05). Conclusion: Leukocyte, Neutrophil, NLR & SII values can be used in the early diagnosis of COVID-19. Keywords: NLR, SII, Leukocyte, Neutrophil

scholarly journals To study association of Neutrophil- Lymphocyte ratio with vascular complications in Type-2 Diabetes

2021 ◽  
Vol 12 (8) ◽  
pp. 16-22
Author(s):  
Shilpa Tumkur Andane Gowda ◽  
Shahari Hegde Kusumakar ◽  
Raveendra Kodur Ramamurthy ◽  
Rohith Maraludevanapura Govindaiah
Keyword(s):  
Type 2 Diabetes ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Medical College ◽  
Increased Risk ◽  
Significant Difference

Background: Diabetes is a pro-thrombotic state associated with increased risk of atherosclerosis and inflammation. Neutrophil lymphocyte ratio (NLR) provides information about early and subclinical inflammation and thus may act as a prognostic marker for vascular complications in type 2 diabetes. Aims and Objective: To analyze the correlation between Neutrophil- Lymphocyte ratio in diabetics with and without vascular complications. Materials and Methods: A total of 111 patients admitted in Victoria hospital and Bowring & Lady Curzon hospital attached to Bangalore Medical College and Research Institute from NOV 2018 to MAY 2020 were studied. The data was collected according to the proforma in terms of history, clinical examination and the necessary investigations. NLR was observed in type 2 diabetic patients and was compared in those with complications and without complications. Results: The NLR was higher in diabetics with vascular complications compared to those without complications, 2.8 ± 0.7 fl versus 6.8 ± 3.1 fl (P< 0.001), respectively. In this study, Mean N (%), In No Vascular Complications was 61.7 ± 10.6 and with vascular complications was 79.9 ± 9.5. Mean L (%) in No Vascular Complications was 23.7 ± 5.8. Mean N (%), In No Vascular Complications was 61.7 ± 10.6 and with vascular complications was 79.9 ± 9.5. There was a significant difference in mean N (%) mean L (%) and NLR in comparison with respect to Complications. Conclusion: This study showed significantly higher NLR in diabetic patients with vascular complications. Hence, NLR can be used as a simple parameter to assess the vascular complications in diabetes.

scholarly journals Peripheral Neutrophil- Lymphocyte Ratio as a Predictor of Seizure in Preterm Infants with Intra-Ventricular Hemorrhage

2021 ◽  
pp. 13-21
Author(s):  
Heba Ibrahim Ashraf ◽  
Abd El-Rahman Mohamed El-Mashad ◽  
Mai Rabie El-Sheikh
Keyword(s):  
Preterm Infants ◽  
University Hospital ◽  
Neurological Dysfunction ◽  
P Value ◽  
Cranial Ultrasound ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference ◽  
Ventricular Hemorrhage ◽  
Peripheral Neutrophil

Background: Preterm infants with Intra-Ventricular Hemorrhage (IVH) are at risk for developing significant complications, including post hemorrhagic hydrocephalus and seizures. Neonatal seizures are the most common overt manifestation of neurological dysfunction in the newborn, and is associated with short- and long-term adverse effects. Objective: The aim of the study is to evaluate the value of Peripheral Neutrophil- lymphocyte ratio (NLR) as a predictor of seizure in preterm infants with intra-ventricular hemorrhage. Methods: This prospective cohort study that comprised 60 Preterm infants with IVH admitted at NICU pediatric department Tanta university hospital from November 2019 to May 2020, Preterm infants were divided into two groups according to incidence of seizure. Preterm infants in this study subjected to Careful history taking, clinical examination and investigations (laboratory and Trans-cranial ultrasound) as well as analysis of result and follow up clinical status for development of seizure. Results: There was a statistically highly significant difference regarding NLR and development of seizure with p value <0.001 (NLR ≥ 2.3 with sensitivity 96%, specificity 93%, Area under the curve 0.849 and accuracy 84.9%). Conclusion: NLR is a predictor of seizure in preterm infants with intra-ventricular hemorrhage.

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