Emergency Medicine Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.
Dermatology Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.
Am J Emerg Med. 2021 Sep;47:279-283. doi: 10.1016/j.ajem.2021.05.029. Epub 2021 May 12.
We aimed to evaluate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in emergency department (ED) patients with cutaneous adverse drug reactions to identify the severe patients at an early stage.
In this retrospective study, patients aged 18 and over who admitted to the ED of a university hospital with the diagnosis of cutaneous adverse drug reaction were included. For included patients, clinical findings and ED admission complete blood count results were recorded. The primary outcome was hospitalization and the secondary outcome was the type of drug reaction.
A total of 135 patients were included in the study. The median age of patients was 50 (36-64) years. There was no significant difference between the patients hospitalized and discharged from the ED in terms of age and gender (p = 0.340 and p = 0.762, respectively). There was no significant difference between hospitalized and discharged patients in terms of complete blood count parameters (p > 0.05, for all). The median NLR of hospitalized patients was significantly higher than that of patients discharged from the ED (6.13 vs. 3.69, p = 0.006). The median NLR of the patients with erythema multiform/Steven Johnson syndrome/toxic epidermal necrosis was significantly higher than the NLR of the patients with maculopapular and fixed drug eruptions (p = 0.022 and p = 0.015, respectively). The area under the curve value of NLR in predicting hospitalization was 0.640 (0.546-0.734). For 8.4 of NLR cutoff value, specificity was 83.9%.
NLR is a useful and simple prognostic parameter as an indicator of systemic inflammatory involvement in ED patients with cutaneous adverse drug reactions. NLR is a useful parameter for deciding which patient will be admitted to the hospital in that patient group.
我们旨在评估中性粒细胞与淋巴细胞比值（NLR）在急诊科（ED）皮肤药物不良反应患者中的预后价值，以便早期识别重症患者。
在这项回顾性研究中，纳入了年龄在 18 岁及以上、因皮肤药物不良反应而入住大学医院 ED 的患者。对纳入的患者，记录其临床特征和 ED 入院时的全血细胞计数结果。主要结局为住院，次要结局为药物反应类型。
共纳入 135 例患者。患者的中位年龄为 50（36-64）岁。住院和 ED 出院患者在年龄和性别方面无显著差异（p = 0.340 和 p = 0.762）。住院和 ED 出院患者的全血细胞计数参数无显著差异（p > 0.05，均）。住院患者的 NLR 中位数显著高于 ED 出院患者（6.13 比 3.69，p = 0.006）。多形红斑/史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症患者的 NLR 中位数显著高于斑丘疹和固定性药物疹患者（p = 0.022 和 p = 0.015）。NLR 预测住院的曲线下面积值为 0.640（0.546-0.734）。NLR 截断值为 8.4 时，特异性为 83.9%。
NLR 是一种有用且简单的预后参数，可作为 ED 皮肤药物不良反应患者全身炎症受累的指标。NLR 是决定该患者群体中哪些患者需要住院的有用参数。
