Neutrophil-lymphocyte ratio in the early diagnosis of sepsis in an intensive care unit: a case-control study

ABSTRACT Objective: To evaluate the neutrophil-lymphocyte ratio as a predictor of sepsis and mortality in patients admitted to an intensive care unit. Methods: Case-control study of adult patients admitted to an intensive care unit. Patients who had sepsis as the reason for admission and who had a previous complete blood count examination were included as case patients. The following statistical analyses were performed: ROC curves, binary logistic regression, and Mann-Whitney and Pearson's chi-square tests. p < 0.05 was considered significant. Results: The ROC curve values were 0.62 for neutrophil-lymphocyte ratio, 0.98 for band neutrophils and 0.51 for total leukocytes. The presence of a neutrophil-lymphocyte ratio greater than 5.0, leukocyte count above 12,000mm3/mL and band neutrophil percentage above 10% were risk factors for sepsis; however, only the SAPS 3 and SOFA score were related to patient mortality. Conclusion: The neutrophil-lymphocyte ratio and band neutrophils in combination with other parameters may be markers for the early detection of sepsis in intensive care units.

摘要
研究目的：评估中性粒细胞与淋巴细胞比值（neutrophil-lymphocyte ratio, NLR）对重症监护病房（intensive care unit, ICU）收治患者脓毒症（sepsis）及死亡结局的预测价值。
研究方法：本研究为针对重症监护病房收治成年患者的病例对照研究。纳入以脓毒症为收治原因且既往完成全血细胞计数检测的患者作为病例组。本研究采用以下统计学分析方法：受试者工作特征（Receiver Operating Characteristic, ROC）曲线、二元logistic回归、曼-惠特尼（Mann-Whitney）检验及皮尔逊卡方（Pearson's chi-square）检验。以p<0.05为差异具有统计学意义。
研究结果：受试者工作特征曲线结果显示，中性粒细胞与淋巴细胞比值的曲线下面积为0.62，中性杆状核粒细胞（band neutrophils）为0.98，白细胞总数（total leukocytes）为0.51。中性粒细胞与淋巴细胞比值＞5.0、白细胞计数＞12000/mm³、中性杆状核粒细胞百分比＞10%均为脓毒症的危险因素；但仅简化急性生理学评分Ⅲ（Simplified Acute Physiology Score 3, SAPS 3）与序贯器官衰竭评估（Sequential Organ Failure Assessment, SOFA）评分与患者死亡结局相关。
研究结论：中性粒细胞与淋巴细胞比值及中性杆状核粒细胞联合其他参数，可作为重症监护病房内脓毒症早期筛查的生物标志物。