Open AccessThe value of the neutrophil-lymphocyte count ratio in the diagnosis of sepsis in patients admitted to the Intensive Care Unit: A retrospective cohort study
Author(s) -
Kim Westerdijk,
Koen S. Simons,
Marissa Zegers,
Peter C. Wever,
Peter Pickkers,
Cornelis P.C. de Jager
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0212861
Subject(s) - medicine , procalcitonin , sepsis , interquartile range , intensive care unit , receiver operating characteristic , retrospective cohort study , absolute neutrophil count , gastroenterology , lymphocyte , white blood cell , neutropenia , chemotherapy
Background Early diagnosis and treatment has proven to be of utmost importance in the outcome of sepsis patients. We compared the accuracy of the neutrophil-lymphocyte count ratio (NLCR) to conventional inflammatory markers in patients admitted to the Intensive Care Unit (ICU). Methods We performed a retrospective cohort study consisting of 276 ICU patients with sepsis and 388 ICU patients without sepsis. We compared the NLCR as well as C-reactive protein (CRP) level, procalcitonin (PCT) level, white blood cell (WBC) count, neutrophil count and lymphocyte count on ICU admission between sepsis and non-sepsis ICU patients. To evaluate the sensitivity and specificity, we constructed receiver operating characteristics (ROC) curves. Results Significant differences in NLCR values were observed between sepsis and non-sepsis patients (15.3 [10.8–38.2] (median [interquartile range] vs. 9.3 [6.2–14.5]; P<0.001), as well as for CRP level, PCT level and lymphocyte count. The area under the ROC curve (AUROC) of the NLCR was 0.66 (95%CI = 0.62–0.71). AUROC was significantly higher for CRP and PCT level with AUROC’s of 0.89 (95%CI 0.87–0.92) and 0.88 (95%CI 0.86–0.91) respectively. Conclusions The NLCR is less suitable than conventional inflammatory markers CRP and PCT to detect the presence of sepsis in ICU patients. Trial registration ClinicalTrials.gov NCT01274819 .