Neutrophil to lymphocyte ratio as a predictor of treatment response and mortality in septic shock patients in the intensive care unit
| Autor: | Feyza Kargin, Rabia Sari, Gokay Gungor, Muhammed Emin Çelik, Zuhal Karakurt, Mustafa Ay, Nalan Adiguzel, Ülgen Yalaz Tekan, Fulya Çiyiltepe, Ozlem Yazicioglu Mocin, Cüneyt Saltürk |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Neutrophils 030204 cardiovascular system & hematology intensive care unit Article law.invention Sepsis Leukocyte Count Young Adult 03 medical and health sciences 0302 clinical medicine Septic shock intensive care unit respiratory failure neutrophil to lymphocyte ratio law Septic shock Internal medicine medicine Risk of mortality Humans Lymphocyte Count Lymphocytes Neutrophil to lymphocyte ratio neutrophil to lymphocyte ratio Aged Retrospective Studies 0303 health sciences 030306 microbiology business.industry fungi respiratory failure General Medicine Odds ratio Middle Aged medicine.disease Shock Septic Intensive care unit Anti-Bacterial Agents C-Reactive Protein Cross-Sectional Studies Respiratory failure Shock (circulatory) Female medicine.symptom business Biomarkers |
| Zdroj: | Volume: 49, Issue: 5 1336-1349 Turkish Journal of Medical Sciences |
| ISSN: | 1303-6165 1300-0144 |
| Popis: | Background/aim: While C-reactive protein (CRP) is a well-studied marker for predicting treatment response and mortality in sepsis, it was aimed to assess the efficacy of the neutrophil lymphocyte ratio (NLR) as a predictor of mortality and treatment response in sepsis patients in the intensive care unit (ICU). Materials and methods: In this retrospective cross-sectional study, sepsis patients were divided according to the presence of septic shock on the 1st day of ICU stay, and then subgrouped according to mortality. Patient demographics, acute physiologic and chronic health evaluation II and sequential organ failure assessment scores, NLR and CRP (on the 1st, 3rd, and last day in the ICU), microbiology data, antibiotic responses, ICU data, and mortality were recorded. Receiver operating characteristic (ROC) curves for the area under curve (AUC) were calculated for the inflammatory markers and ICU severity scores for mortality.Results: Of the 591 (65% male) enrolled patients, 111 (18.8%) were nonsurvivors with shock, 117 (19.8%) were survivors with shock, 330 (55.8%) were survivors without shock, and 33 (5.6%) were nonsurvivors without shock. On the 1st day of ICU stay, the NLR and CRP were similar in all of the groups. On the 3rd day of antibiotic response, the NLR was increased (11.8) in the nonresponsive patients when compared with the partially responsive (11.0) and responsive (8.5) patients. If the NLR was ≥15 on the 3rd day, the mortality odds ratio was 6.96 (CI: 1.4?34.1, P < 0.017). The NLR and CRP on the 1st, 3rd, and last day of ICU stay (0.52, 0.58, 0.78 and 0.56, 0.70, 0.78, respectively) showed a similar increasing trend for mortality. Conclusion: The NLR can predict mortality and antibiotic responsiveness in ICU patients with sepsis and septic shock. If the NLR is >15 on the 3rd day of postantibiotic initiation, the risk of mortality is high and treatment should be reviewed carefully. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|