Diagnostic and Therapeutic Medicine Department, University Campus Bio-Medico of Rome, 00128 Roma, Italy.
Unit of Clinical Laboratory Science, University Campus Bio-Medico of Rome, 00128 Roma, Italy.
Medicina (Kaunas). 2021 Aug 7;57(8):811. doi: 10.3390/medicina57080811.
: The aim of this study was to evaluate the diagnostic accuracy and prognostic value of neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios and to compare them with other biomarkers and clinical scores of sepsis outside the intensive care unit. : In this retrospective study, 251 patients with sepsis and 126 patients with infection other than sepsis were enrolled. NLR and PLR were calculated as the ratio between absolute values of neutrophils, lymphocytes, and platelets by complete blood counts performed on whole blood by XE-9000 (Dasit, Italy) following the manufacturer's instruction. : The best NLR value in diagnosis of sepsis was 7.97 with sensibility, specificity, AUC, PPV, and NPV of 64.26%, 80.16%, 0.74 ( < 0.001), 86.49%, and 53.18%, respectively. The diagnostic role of NLR significantly increases when PLR, C-reactive protein (PCR), procalcitonin (PCT), and mid-regional pro-adrenomedullin (MR-proADM) values, as well as systemic inflammatory re-sponse syndrome (SIRS), sequential organ failure assessment (SOFA), and quick-sequential organ failure assessment (qSOFA) scores, were added to the model. The best value of NLR in predicting 90-day mortality was 9.05 with sensibility, specificity, AUC, PPV, and NPV of 69.57%, 61.44%, 0.66 ( < 0.0001), 28.9%, and 89.9%, respectively. Sensibility, specificity, AUC, PPV, and NPV of NLR increase if PLR, PCR, PCT, MR-proADM, SIRS, qSOFA, and SOFA scores are added to NLR. : NLR and PLR represent a widely useful and cheap tool in diagnosis and in predict-ing 90-day mortality in patients with sepsis.
: 本研究旨在评估中性粒细胞与淋巴细胞(NLR)和血小板与淋巴细胞(PLR)比值的诊断准确性和预后价值,并将其与重症监护室外其他脓毒症的生物标志物和临床评分进行比较。 : 在这项回顾性研究中,纳入了 251 例脓毒症患者和 126 例非脓毒症感染患者。NLR 和 PLR 是根据 XE-9000(Dasit,意大利)全血计数检测的中性粒细胞、淋巴细胞和血小板绝对值计算得出的,具体操作遵循制造商的说明。 : NLR 诊断脓毒症的最佳值为 7.97,其敏感性、特异性、AUC、PPV 和 NPV 分别为 64.26%、80.16%、0.74(<0.001)、86.49%和 53.18%。当 NLR 值与 PLR、C 反应蛋白(PCR)、降钙素原(PCT)和中区域肾上腺髓质肽(MR-proADM)以及全身炎症反应综合征(SIRS)、序贯器官衰竭评估(SOFA)和快速序贯器官衰竭评估(qSOFA)评分等指标联合应用时,NLR 的诊断作用显著增强。NLR 预测 90 天死亡率的最佳值为 9.05,其敏感性、特异性、AUC、PPV 和 NPV 分别为 69.57%、61.44%、0.66(<0.0001)、28.9%和 89.9%。如果将 PLR、PCR、PCT、MR-proADM、SIRS、qSOFA 和 SOFA 评分加入 NLR,NLR 的敏感性、特异性、AUC、PPV 和 NPV 将会提高。 : NLR 和 PLR 是一种广泛有用且廉价的工具,可用于诊断和预测脓毒症患者 90 天的死亡率。