COMPARATIVE STUDY TO ASSESS THE EFFICACY OF EOSINOPHIL COUNT AND NEUTROPHIL-LYMPHOCYTE COUNT RATIO VERSUS PROCALCITONIN LEVELS IN PATIENTS WITH SEPSIS.

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.

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Eosinophil count and neutrophil-to-lymphocyte count ratio as biomarkers for predicting early-onset neonatal sepsis

Korean Journal of Pediatrics ◽

10.3345/kjp.2019.00297 ◽

2019 ◽

Vol 62 (12) ◽

pp. 438-439 ◽

Cited By ~ 1

Author(s):

Jang Hoon Lee

Keyword(s):

Neonatal Sepsis ◽

Early Onset ◽

Eosinophil Count ◽

Lymphocyte Count ◽

Count Ratio

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Eosinophil Count and Neutrophil-Lymphocyte Count Ratio as Prognostic Markers in Patients with Bacteremia: A Retrospective Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0042860 ◽

2012 ◽

Vol 7 (8) ◽

pp. e42860 ◽

Cited By ~ 65

Author(s):

Roser Terradas ◽

Santiago Grau ◽

Jordi Blanch ◽

Marta Riu ◽

Pere Saballs ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Eosinophil Count ◽

Lymphocyte Count ◽

Retrospective Cohort ◽

Prognostic Markers ◽

Count Ratio

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Role of eosinophil count and neutrophil: lymphocyte count ratio as prognostic markers in patients with sepsis

International Surgery Journal ◽

10.18203/2349-2902.isj20172774 ◽

2017 ◽

Vol 4 (7) ◽

pp. 2243

Author(s):

Prasan Kumar Hota ◽

B. Gowtham Reddy

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Eosinophil Count ◽

Lymphocyte Count ◽

Prognostic Markers ◽

Low Cost ◽

Neutrophil Lymphocyte Ratio ◽

Count Ratio ◽

Diagnosis And Prognosis

Background: Several biomarkers, such as C-reactive protein (CRP) and Procalcitonin have been used to indicate bacterial infection in sepsis. They have limited sensitivity and specificity with high cost, placing them practically out of reach for poor patients in developing countries like India. Hence the need to evaluate eosinophil count and neutrophil-lymphocyte count ratio (NLCR) as an indicator of sepsis considering their lower cost and easier accessibility. The present study was done to establish that eosinopenia and the neutrophil-lymphocyte count are simple and effective tools as prognostic biomarkers for sepsis.Methods: A prospective observational study consisting of 50 patients with SIRS and sepsis on admission were studied. Neutrophil and lymphocyte count for first 4 consecutive days and then on alternate days up to one week was done. Absolute eosinophil count for first 2 consecutive days and then on alternate days up to one week was done.Results: Eosinopenia was noted to have 79.3% sensitivity, 76.2% specificity, positive predictive value 82.2% and negative predictive value 95.4% in predicting diagnosis and prognosis of sepsis. Neutrophil-lymphocyte ratio was found to have 86.2% sensitivity, 85.7% specificity, positive predictive value of 89.2%, negative predictive value of 81.1% in predicting diagnosis and prognosis of sepsis.Conclusions: Eosinophil count and neutrophil - lymphocyte count ratio are simple and effective prognostic markers of sepsis with low cost.

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Neutrophil to Lymphocyte Count Ratio Has a Close Association With Severe Acute Colonic Diverticulitis in Patients Undergoing Surgical Treatment

International Surgery ◽

10.9738/intsurg-d-17-00120.1 ◽

2017 ◽

Vol 102 (11-12) ◽

pp. 514-521

Author(s):

TaeHoon Kim ◽

Tong Moon ◽

Jin Yoon ◽

SangSu Park ◽

YongSeog Jang ◽

...

Keyword(s):

Surgical Treatment ◽

Treatment Group ◽

Conservative Management ◽

Lymphocyte Count ◽

Acute Diverticulitis ◽

White Blood Cells ◽

Colonic Diverticulitis ◽

Count Ratio ◽

Co Morbidity ◽

Acute Colonic Diverticulitis

Objective: To investigate the diagnostic potential of neutrophil-to-lymphocyte count ratio (NLCR) for acute diverticulitis. Summary of Background Data: We evaluated NLCR in patients with acute colonic diverticulitis who were treated with conservative and surgical treatments. Methods: A total of 205 patients who underwent surgical treatment or conservative management of acute diverticulitis between 2012 and 2016 were reviewed. Patients' age; sex; hospital days; co-morbidity; complication; period of use of antibiotics; treatment method; body temperature; and initial laboratory results such as neutrophil count, lymphocyte count, NLCR, and serum levels of C-reactive protein (CRP) were assessed. Results: The median ages of the conservative and surgical treatment groups were 46 and 68 years, respectively. Median CRP and glucose levels were high in acute colonic diverticulitis patients who underwent surgical treatment (P < 0.001, P < 0.001). Albumin level was low in the surgical treatment group (P < 0.001). NLCR was significantly different in both groups (conservative management vs surgical treatment, 4.1 mg/L versus 8.5 mg/L; P < 0.001). Median white blood cells was 11.36 × 109/L in the conservative management group and 14.0 × 109/L in the surgical treatment group, with no significance (P = 0.071). Multivariate analysis revealed that NLCR >10.21 [odds ratio (OR) = 5.613, P = 0.022]; CRP >17.23 mg/L (OR = 4.241, P = 0.006); and albumin ≤3.5 (OR = 4.192, P = 0.036) were significant for acute colonic diverticulitis patients. Conclusion: NLCR, CRP, and albumin levels were significantly associated with acute colonic diverticulitis in the surgical treatment group, and NLCR was the most powerful predictive marker of severe acute colonic diverticulitis.

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Neutrophil-to-lymphocyte count ratio in predicting prognosis of septic shock patients

QJM ◽

10.1093/qjmed/hcab086.080 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hoda Omar Mahmoud ◽

Niven Gerges Fahmy ◽

Mona Ahmed Mohamed Abdelmotaleb Ammar ◽

Mostafa Mansour Mohamed Elsaid ELryany

Keyword(s):

Septic Shock ◽

Intensive Care ◽

Lymphocyte Count ◽

Late Mortality ◽

Late Death ◽

Tertiary Referral Center ◽

Risk Of Death ◽

Count Ratio ◽

Significant Difference ◽

Common Causes

Abstract Background Septic shock is one of the most common causes of admission to the intensive care unit in the world and one of the most common causes of death among intensive care patients. Since the definition of sepsis and septic shock and many studies have been designed to understand everything about sepsis regarding mechanism, pathophysiology, complications, diagnosis, management and all other aspects. Objective To find the association between neutrophil to lymphocyte count ratio and the mortality from septic shock patients. The work aims also to determine if this ratio can be used as a prognostic marker of septic shock patients and to compare this ratio with other sepsis markers as C-reactive protein (CRP) and procalcitonin. Patients and Methods This study was conducted prospectively in critical care unit in Ain Shams Hospital, a university-affiliated, tertiary referral center in Cairo, Egypt. Study subjects included 125 patients between January 2018 to January 2019. The ethics committee of our institution approved the study protocol, and written informed consent was obtained from each patient’s family. Results In our study, the neutrophils count was significantly increased in survived patients compared with early and late mortality patients in day 1 while lymphocytes count was lower in survived patient than early and late mortality patients and the NLCR in our study was higher in survived patients than early and late mortality patients. In day 4, our results revealed significant increase in neutrophils count in patients of late mortality compared with its count in survived patients, while lymphocytes didn't show any significant difference compared with its count in survived patients with significant increase in NLCR in patients of late mortality compared with those of survived patients in day 4. Both CRP and procalcitonin are increased in patients of early and late mortality groups compared with its value in survived patients in day 1 and 4. Conclusion This study demonstrates a real relationship between the NLCR and the risk of death in septic shock patients. Septic shock patients at risk of early death presented a low NLCR at admission, although late death was associated with an increased NLCR during the first 5 days. Early and late death should be distinguished because they may involve different underlying mechanisms, and the NLCR might be considered as a discriminant indicator of early or late death. In addition, our findings provide more insight into biology. The circulating neutrophil and lymphocyte trends observed in this study offer an interesting mechanistic viewpoint. We observed that circulating lymphocytes and the NLCR behave in opposite ways in early- and late death patients, supporting the hypothesis that divergent mechanisms could be involved in these two groups.

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The Value of Neutrophil-Lymphocyte Count Ratio for Disease Severity in Nursing Home Acquired Pneumonia Patients

Journal of the Korean Geriatrics Society ◽

10.4235/jkgs.2013.17.4.213 ◽

2013 ◽

Vol 17 (4) ◽

pp. 213-218 ◽

Cited By ~ 1

Author(s):

Dong Yoon Rhee ◽

Sang Hyun Park ◽

Han Jo Choi ◽

Mi Kyung Kwon ◽

Dong Hui Cho

Keyword(s):

Nursing Home ◽

Disease Severity ◽

Lymphocyte Count ◽

Count Ratio

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NEUTROPHIL-LYMPHOCYTE COUNT RATIO (NLR) WAS ASSOCIATED WITH DISEASE ACTIVITY IN TUBERCULOSIS AND DIABETIC MELLITUS PATIENTS

Respirology ◽

10.1111/resp.13420_315 ◽

2018 ◽

Vol 23 ◽

pp. 204-204

Keyword(s):

Disease Activity ◽

Lymphocyte Count ◽

Diabetic Mellitus ◽

Count Ratio

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CORRELATION OF MONOCYTE COUNT, MLR AND NLCR WITH PRESEPSIN LEVEL IN SIRS (Hubungan Jumlah Monosit, MLR dan NLCR dengan Kadar Presepsin pada SIRS)

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v22i3.1234 ◽

2018 ◽

Vol 22 (3) ◽

pp. 212

Author(s):

Nurmalia PS ◽

N. Suci W ◽

Imam BW

Keyword(s):

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Enzyme Immunoassay ◽

Lymphocyte Count ◽

Systemic Inflammatory Response ◽

Monocyte Count ◽

Lymphocyte Ratio ◽

Count Ratio ◽

Hematology Analyzer ◽

Chemiluminescent Enzyme Immunoassay

Systemic Inflammatory Response Syndrome (SIRS) mempunyai kebahayaan tinggi terjadi sepsis dan kematian. Nilai jumlahkeseluruhan leukosit merupakan salah satu peramal pasien SIRS dengan bakteriemia. Pemeriksaan jumlah monosit, angka bandinglimfosit Monocyte-Lymphocyte Ratio (MLR), Neutrophil-Lymphocyte Count Ratio (NLCR) dapat diketahui dengan pemeriksaan leukosit.Presepsin telah diteliti untuk mencerminkan kondisi sepsis. Penelitian ini bertujuan untuk mengetahui keberadaan hubungan jumlahmonosit, MLR dan NLCR dengan presepsin di SIRS lewat pembuktian. Ada 34 pasien SIRS di ICU RSUP Dr. Kariadi, diambil secaraberturutan antara selama bulan Januari−Februari 2014. Pemeriksaan darah rutin dengan hematology analyzer. MLR dan NLCR dihitung secara manual. Kadar presepsin ditentukan dengan metode Chemiluminescent Enzyme Immunoassay (CLEIA). Uji kenasabanPearson untuk hubungan MLR dan NLCR dengan presepsin. Uji kenasaban Spearman untuk jumlah monosit dengan presepsin. Kadarpresepsin subjek penelitian 286–15687 pg/mL. Terdapat 23(67,8%) subjek yang mempunyai jumlah monosit dalam rentang nilai rujukan.24(70,6%) dan memiliki jumlah neutrofil absolut lebih besar dari rentang nilai rujukan, sedangkan 21(61,8%) mempunyai jumlahlimfosit absolut dalam rentang nilai rujukan. Hubungan jumlah monosit dengan presepsin mempunyai nilai r= -0,204; p=0,247;yang terkait MLR dengan presepsin r=0,163; p=0,358; sedangkan NLCR dengan presepsin r=0,345; p=0,046. Didasari telitian ini,dapat disimpulkan tidak terdapat hubungan bermakna antara jumlah monosit dan MLR dengan presepsin, selain itu didapatkan pulahubungan positif berarti antara NLCR dan presepsin di SIRS.

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