scholarly journals Procalcitonin and C-reactive Protein Perform Better Than Neutrophil-Lymphocyte Count Ratio on Evaluation of Hospital Acquired Pneumonia

2020 ◽  
Author(s):  
Nan Zheng ◽  
Dongmei Zhu New ◽  
YI HAN
Keyword(s):  
Lymphocyte Count ◽  
Diagnostic Performance ◽  
Multivariable Analysis ◽  
Previous History ◽  
Roc Curves ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Count Ratio ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Abstract Background: The relationship between biomarkers and hospital acquired pneumonia (HAP) is under studied, especially those severe cases admitted to the intensive care unit (ICU). Compared with community acquired pneumonia (CAP), HAP might have different traits regarding biomarkers due to the previous history in the hospitals. Methods: 593 adult patients were enrolled into this retrospective cohort study to determine neutrophil-lymphocyte count ratio (NLCR), procalcitonin (PCT), C-reactive protein (CRP) and serum lactate level at the admission of ICU. According to the diagnosis, patients were divided into two groups: non-infection and HAP. Discriminant analysis was performed based on better outcomes of diagnostic performance and severity evaluation. The diagnostic performance of each individual biomarker was assessed by construction of receiver operating characteristic (ROC) curves and calculation of the area under each ROC curves (AUROC). Multivariable analysis was also applied to determine most appropriate prognostic factors. Results: NLCR, PCT and CRP between non-infection and HAP group showed remarkable differences. Because of discriminant ability of severe infection, the AUROC of NLCR (0.626; 95%CI 0.581-0.671) was not comparative with conventional markers such as CRP (0.685; 95% CI 0.641-0.730) and PCT (0.661; 95% CI 0.615-0.707). Besides, AUROC of composite biomarkers, especially the combination of NLCR, CRP and WBC, were significantly greater than the single biomarkers. Conclusions: NLCR was not comparable to conventional single biomarkers such as CRP and PCT regarding to diagnosis or severity evaluation of HAP. Composite biomarkers could prompt early diagnosis and severity evaluation with improved accessibility, especially the combination of NLCR, CRP and WBC.

scholarly journals Procalcitonin and C-reactive Protein Perform Better Than Neutrophil-Lymphocyte Count Ratio on Evaluation of Hospital Acquired Pneumonia

2020 ◽  
Author(s):  
Nan Zheng ◽  
YI HAN
Keyword(s):  
Early Diagnosis ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Discriminant Ability ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Abstract Background: Early diagnosis and severity evaluation are key factors to achieve improved outcomes of hospital acquired pneumonia (HAP). We are constantly in search of more sensitive and specific biomarkers to improve timely diagnosis and survival.Methods: 593 cases of adult patients were enrolled into this retrospective cohort study to determine neutrophil-lymphocyte count ratio (NLCR), procalcitonin (PCT), C-reactive protein (CRP), serum lactate level and APACHE (Acute Physiology and Chronic Health Evaluation) II score at the admission of ICU. Patients were divided into 2 groups according to diagnosis: non-infection and HAP. Discriminant analysis was applied to which marker or what composition of markers performed better regarding to the diagnostic value and severity evaluation. The diagnostic value of each individual biomarker was assessed by construction of receiver operating characteristic (ROC) curves, calculation of the area under each ROC curves (AUROC). Multivariate analysis was also applied to detect most appropriate prognostic factors.Results: Remarkable differences were observed on NLCR, PCT, CRP and APACHE II scores between non-infection and HAP group. Regarding to discriminant ability of severe infection, the AUROC of NLCR (0.56; 95%CI 0.52-0.61) was not comparative with any of other single markers such as PCT (0.63; 95% CI 0.59-0.68), CRP (0.60; 95% CI 0.54-0.67), or APACHE II score (0.68; 95% CI 0.64-0.73). Compared to the single biomarkers, APACHE II score presented higher discriminant ability with greater AUROC. Besides, AUROC of the composite biomarker PCT-CRP-NLCR (0.66; 95% CI 0.61-0.70) was significantly greater than any of the single biomarkers, and its discriminant ability was comparable to APACHE II score.Conclusions: NLCR is not comparable to other single biomarkers such as PCT, CRP, or APACHE II score regarding to diagnosis or to severity evaluation of HAP. Composite biomarkers can prompt early diagnosis and severity evaluation with improved accessibility, especially the composition of PCT-CRP-NLCR.

scholarly journals Diagnostic accuracy of procalcitonin, neutrophil-lymphocyte count ratio, C-reactive protein, and lactate in patients with suspected bacterial sepsis

PLoS ONE ◽  
2017 ◽  
Vol 12 (7) ◽  
pp. e0181704 ◽  
Author(s):  
Lars Ljungström ◽  
Anna-Karin Pernestig ◽  
Gunnar Jacobsson ◽  
Rune Andersson ◽  
Barbara Usener ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Lymphocyte Count ◽  
Bacterial Sepsis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Count Ratio

scholarly journals The prognostic and risk-stratified value of neutrophil–lymphocyte count ratio in Chinese patients with community-acquired pneumonia

2017 ◽  
Vol 15 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Ting Yang ◽  
Chun Wan ◽  
Hao Wang ◽  
Jiangyue Qin ◽  
Lei Chen ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Lymphocyte Count ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Serum Levels ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Pneumonia Severity ◽  
Reactive Protein ◽  
Count Ratio

Community-acquired pneumonia is a common disease associated with high mortality. This retrospective study examined whether the neutrophil–lymphocyte count ratio (NLR), already widely used as an index of inflammation, can be used to predict in-hospital mortality of adults with community-acquired pneumonia. Clinical characteristics, CURB-65 and pneumonia severity index score of pneumonia severity, NLR, serum levels of C-reactive protein and procalcitonin, and in-hospital mortality were analyzed for 318 consecutive adults with community-acquired pneumonia admitted to West China Hospital between July 2012 and December 2013. The ability of NLR and other parameters to predict in-hospital mortality was assessed using receiver operating characteristic (ROC) curves. Results showed that NLR increased with increasing CURB-65 ( P < 0.05) and pneumonia severity index ( P < 0.05), and NLR correlated positively with serum levels of C-reactive protein (r = 0.239, P < 0.05) and procalcitonin (r = 0.211, P < 0.05). The median value of NLR was significantly higher among patients who died in hospital (11.96) than among those who were alive at the end of hospitalization (4.19, P < 0.05). Based on a cut-off NLR of 7.12, this index predicted in-hospital mortality with a sensitivity of 82.61% and specificity of 72.20% (area under ROC curve, 0.799). Predictive power was greater for the combination of NLR and serum levels of C-reactive protein and procalcitonin. These results suggest that NLR may be useful for predicting prognosis in Chinese adults with community-acquired pneumonia, and it may work better in combination with traditional markers.

scholarly journals Evaluation of eosinophil count and neutrophil-lymphocyte count ratio versus C-reactive protein levels in patients with sepsis

2017 ◽  
Vol 5 (11) ◽  
pp. 4754
Author(s):  
Rahul Khajuria ◽  
Vinu Jamwal ◽  
Anil K. Gupta ◽  
Abhinav Gupta
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Critically Ill Patients ◽  
Eosinophil Count ◽  
Lymphocyte Count ◽  
Sepsis Group ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Count Ratio

Background: One major problem encountered in the intensive care unit is differentiating the inflammatory response from an infective process. Clinical and standard laboratory tests are not very helpful because most critically ill patients develop some degree of inflammatory response, whether or not they have sepsis. Numerous biomarkers have been evaluated to predict mortality in critically ill patients, although none have proved entirely useful. Objective of the study was to evaluate eosinophil count and neutrophil-lymphocyte count ratio with C-reactive protein levels in patients with sepsis.Methods: 71 patients >18 years of age of either sex with a diagnosis of sepsis were enrolled in this one-year observational study. Patients were classified according to the criteria of the American College of Chest Physicians/Society of Critical Care Medicine into sepsis group (n=50) and no sepsis group (n=21). Sepsis group were further divided into subgroups: sepsis (n=19), severe sepsis (n=16) and septic shock (n=15). Absolute eosinophil cell, neutrophil and lymphocyte counts for first 4 consecutive days and then on alternate days up to one week were also noted down. C-reactive protein levels on day 3 were also noted down.Results: In the sepsis group, mean eosinophil count was significantly (p<0.0001) low, mean neutrophil/lymphocyte count ratio was significantly (p<0.0001) high, mean CRP count was significantly (p=0.019) more as compared to that of no sepsis group. Among 16 mortalities, significant (p<0.05) decrease was noted in mean eosinophil count from day 3 onwards in patients of sepsis and septic shock subgroups. Mean N/L ratio showed no significant difference in patients of sepsis, severe sepsis or septic shock. Mean CRP count showed significant (p<0.05) increase in severe sepsis patients and mean Apache II score showed significant (p<0.05) deterioration in patients of septic shock.Conclusions: Neutrophil/lymphocyte count ratio (NLCR) and absolute eosinophil count (AEC) came out as better independent biomarker of sepsis in critically ill patients with infection admitted in intensive care unit. Diagnostic performance was better in these two diagnostic markers as compared to CRP marker. NLCR presented with sensitivity of 89.58%, AEC with 82.35% and CRP with 80.77%. Outcomes of NLCR and AEC were quick, easy and economical in establishing diagnosis of sepsis.

scholarly journals The Dynamical Assessment of Inflammatory Biomarkers in Predicting the Outcome of Septic Patients and the Response to Antimicrobial Therapy

2020 ◽  
Vol 6 (1) ◽  
pp. 25-31
Author(s):  
Alina Orfanu ◽  
Victoria Aramă ◽  
Cristina Popescu ◽  
Cătălin Tilişcan ◽  
Adrian Streinu-Cercel ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Lymphocyte Count ◽  
Unfavorable Outcome ◽  
Inflammatory Biomarkers ◽  
Prospective Analysis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Count Ratio ◽  
Baseline Values ◽  
Kinetics Of

AbstractAimsTo evaluate the kinetics of inflammatory biomarkers in septic patients in order to identify the most reliable predictor of unfavorable outcome.MethodsA prospective analysis of septic patients was performed. Median levels of neutrophil/lymphocyte count ratio, fibrinogen, C-reactive protein and procalcitonin were dynamically assessed and comparatively analyzed.ResultsSeventy-seven patients were included. Descendent kinetic patterns were registered for all biomarkers, except C-reactive protein. At 24 hours, neutrophil/lymphocyte count ratio significantly decreased in 42.85% of cases, procalcitonin in 37.33%, C-reactive protein in 16.12% and fibrinogen in 1.58% of cases. At 72 hours, procalcitonin decreased to one-half in 70% of cases and neutrophil/lymphocyte count ratio in 67.53% of cases.ConclusionsNeutrophil/lymphocyte count ratio and procalcitonin significantly decreased in the first 72 hours, while C-reactive protein increased in the first 24 hours. The proportions of patients with major decrease of baseline values were higher for neutrophil/lymphocyte count ratio and procalcitonin.

scholarly journals An emerging marker predicting the severity of COVID-19: Neutrophil-Lymphocyte Count Ratio

2020 ◽  
Author(s):  
Minping Zhang ◽  
Enhua Xiao ◽  
Jiayi Liu ◽  
Yeyu Cai ◽  
Qizhi Yu
Keyword(s):  
Neutrophil Count ◽  
Lymphocyte Count ◽  
Clinical Symptoms ◽  
Characteristic Curve ◽  
C Reactive Protein ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Count Ratio ◽  
Severe Group ◽  
D Dimer

Abstract Background: To analyze clinical features and laboratory indicators and identify the markers of exacerbation in COVID-19. Methods: We reviewed clinical histories of 177 patients with confirmed COVID-19. The patients were categorized into mild group (153 patients) and severe group (24 patients). The baseline demographic and laboratory indicators of all patients were collected, including the neutrophil-lymphocyte count ratio (NLCR) and C-reactive protein to albumin ratio (CAR). Receiver operating characteristic curve (ROC) analysis was performed to search for indicators predicting exacerbation in COVID-19 patients, and acquiring the area under the curves (AUCs), sensitivity, specificity and cut-off value. Results: The age of the severe group were significantly older than those of the mild group (P <0.01). Fever was the typical symptom in all COVID-19 patients. Cough and fatigue were manifested in mild group, yet severe patients were more prominent in dyspnea. The laboratory indicators showing that the mild group mainly had an elevated C-reactive protein; the severe group had a decreased lymphocyte count and lymphocyte ratio. WBC, neutrophil count, neutrophil ratio, D-dimer, AST, ALT, LDH, BUN, CRP levels increased. Furthermore, compared to mild group, WBC, neutrophil count, neutrophil ratio (Neut%), D-dimer, total bilirubin, albumin, AST, ALT, LDH, BUN, creatine kinase, CRP, CAR, NLCR were significantly higher, the lymphocyte count, lymphocyte ratio, and APTT were significantly lower in severe group (P<0.05). The ROC indicating that NLCR, Neut%, CAR, CRP, and LDH were better at distinguishing mild and severe patients. The AUCs of NLCR was larger than others (NLCR>Neut%>CAR>CRP>LDH: 0.939>0.925>0.908>0.895>0.873), which suggested that NLCR was the optimal maker; a cut-off value for NLCR of 6.15 had 87.5% sensitivity and 97.6% specificity for predicting exacerbation in COVID-19 patients. Conclusions: The different types of COVID-19 had significant differences in age, clinical symptoms and laboratory indicators, and severe patients might be easier to suffer from the multiple organ damage. An elevated NLCR may indicate that the disease was progressing towards exacerbation. It was essential to dynamically monitor the serum NLCR levels which contributed to evaluate the patient's condition and efficacy. NLCR could be used as a novel, highly specific and sensitive marker for predicting severity of COVID-19 patients.

scholarly journals NEUTROPHIL-LYMPHOCYTE COUNT RATIO IN BACTERIAL SEPSIS (Rasio Neutrofil-Limfosit Pada Sepsis Bakterial)

2018 ◽  
Vol 23 (3) ◽  
pp. 257
Author(s):  
Danny Luhulima ◽  
Marwito Marwito ◽  
Eva O
Keyword(s):  
Lymphocyte Count ◽  
Bacterial Sepsis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Count Ratio ◽  
Pct Procalcitonin

Sepsis akibat infeksi bakteri merupakan masalah kegawatdaruratan medik yang serius sehingga memerlukan penanganan cepat dantepat. Saat ini C-RP (C- reactive protein) dan PCT (procalcitonin) sering digunakan sebagai petanda sepsis bakterial. Sepsis adalah infeksiyang disertai inflamasi sistemik. Respons fisiologis terhadap inflamasi sistemik adalah peningkatan jumlah neutrofil dan penurunanjumlah limfosit, sehingga gabungan perbandingan neutrofil dan limfosit Neutrophil Lymphocyte Count Ratio (NLCR)) dapat digunakansebagai petanda sepsis. Penelitian ini bertujuan untuk mengetahui kepekaan dan kekhasana dari uji NLCR di pasien sepsis akibatinfeksi bakteri. Terdapat 70 pasien SIRS dengan rentang usia 14–70 tahun di RS Mitra Keluarga Bekasi Timur dan RS FK - UKI Jakartamasa waktu bulan Juli–September 2015. Penelitian ini merupakan studi observasional komparatif dan potong lintang. Hasil penelitianmenunjukkan uji NLCR terhadap sepsis bakterial berdasarkan kurva ROC memiliki kepekaan 97,8% dan kekhasan 84,0% pada cutoff ≥6,4 (AUC: 0,94, nilai p<0,05). Neutrophil lymphocyte count ratio dapat diandalkan sebagai petanda sepsis bakterial dengan ujikepekaan dan kekhasan yang baik.

scholarly journals Comparison Neutrophil to Lymphocyte Count Ratio with C-Reactive Protein as a Predictor for Neonatal Sepsis

2021 ◽  
Vol 6 (2) ◽  
pp. 135-144
Author(s):  
Irfan Dzakir Nugroho ◽  
◽  
Dwi Hidayah ◽  
Harsono Salimo ◽  
◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Lymphocyte Count ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Count Ratio
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