Premium
Neutrophil : lymphocyte ratio is associated with disease severity and mortality in patients with Stevens–Johnson syndrome/toxic epidermal necrolysis
Author(s) -
Wang Qian,
Lan YunPing,
Qi Bo,
Yin Lin,
Zhang LiXia,
Liu Wei
Publication year - 2021
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.15968
Subject(s) - toxic epidermal necrolysis , medicine , procalcitonin , gastroenterology , neutrophil to lymphocyte ratio , odds ratio , lymphocyte , univariate analysis , receiver operating characteristic , retrospective cohort study , confidence interval , multivariate analysis , dermatology , sepsis
ABSTRACT The neutrophil : lymphocyte ratio (NLR), platelet : lymphocyte ratio (PLR), C‐reactive protein : albumin ratio (CAR), and albumin : fibrinogen ratio (AFR) have been considered as useful inflammatory biomarkers. However, their roles in Stevens–Johnson Syndrome (SJS)/toxic epidermal necrolysis (TEN) still remain unclear. This study aimed to test whether NLR, PLR, CAR, and AFR serve as predictive markers of disease severity and systemic inflammation in patients with SJS/TEN. This retrospective study included 40 patients with SJS/TEN and 60 healthy controls. The correlation between these markers and severity‐of‐illness score for toxic epidermal necrolysis (SCORTEN), ABCD‐10, procalcitonin (PCT), C‐reactive protein (CRP) were analyzed and compared. Univariable and multivariable analysis were used to assess associations of variables with mortality. The receiver–operator curves (ROC) were used to evaluate the predictive value of variables for mortality in SJS/TEN patients. The results demonstrated that the NLR and PLR of SJS/TEN patients were significantly higher and the AFR was significantly lower when compared with healthy controls ( p < 0.05). The NLR and CAR were positively correlated with SCORTEN, ABCD‐10, PCT, and CRP. The NLR in SCORTEN of ≥3 group was significantly higher than that in SCORTEN <3 group ( p < 0.05) and there were no significant differences between PLR, CAR, and AFR between the two groups. The univariate analysis suggested that NLR of >5.79 was a risk factor for mortality (odds ratio, 10.5; p < 0.05), but the association was no longer statistically significant in multivariable analysis. The ROC showed that NLR had a sensitivity of 85.7% and specificity of 63.6% for predicting death with a cut‐off value of 5.79 ( p < 0.05) in SJS/TEN patients. In conclusion, among the four markers, NLR and CAR can partially reflect severity and inflammatory status in patients with SJS/TEN. NLR was also a predictor of death.