Intensive Care Unit, Hospital Universitario de Canarias, Tenerife, Spain.
Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Santa Cruz Tenerife, Spain.
Enferm Infecc Microbiol Clin (Engl Ed). 2022 May;40(5):235-240. doi: 10.1016/j.eimce.2020.11.022.
The neutrophil-to-lymphocyte ratio (NLR) in the diagnosis of sepsis has been found to be higher in non-survivors than in survivors, and that is associated with mortality. A higher NLR in non-survivors than in survivors has been reported in two studies during patient follow-up; however, NLR was not controlled for sepsis severity. Thus, the objective of this study was to determine whether there is an association between NLR in the first seven days and mortality controlling for sepsis severity.
This observational study, which included septic patients, was conducted in the Intensive Care Units of 3 Spanish hospitals. NLR was recorded on the first, fourth, and eighth day of sepsis. Multiple logistic regression analyses were carried out to determine the association between NLR during the first 7 days of sepsis diagnosis and mortality controlling for sepsis severity.
Thirty-day non-surviving patients (n=68) compared to surviving patients (n=135) showed higher NLR on the first (p<0.001), fourth (p<0.001), and eighth (p<0.001) day of sepsis diagnosis. Multiple logistic regression analysis found an association between NLR at days first (p<0.001), fourth (p=0.004), and eighth (p=0.01) of sepsis diagnosis and mortality controlling for SOFA and lactic acid in those days.
The new finding of our study was the association between NLR in the first seven days of sepsis and mortality controlling for sepsis severity.
中性粒细胞与淋巴细胞比值（NLR）在脓毒症的诊断中，发现在非存活者中高于存活者，且与死亡率相关。在两项患者随访研究中，报告了非存活者的 NLR 高于存活者；然而，NLR 并未针对脓毒症严重程度进行控制。因此，本研究的目的是确定在控制脓毒症严重程度的情况下，前七天的 NLR 是否与死亡率相关。
这是一项观察性研究，纳入了脓毒症患者，在西班牙的 3 家医院的重症监护病房进行。记录脓毒症的第 1、4 和 8 天的 NLR。进行多项逻辑回归分析，以确定脓毒症诊断的前 7 天内 NLR 与死亡率之间的关系，同时控制脓毒症严重程度。
30 天非存活患者（n=68）与存活患者（n=135）相比，在脓毒症诊断的第 1 天（p<0.001）、第 4 天（p<0.001）和第 8 天（p<0.001）的 NLR 更高。多变量逻辑回归分析发现，在脓毒症的第 1 天（p<0.001）、第 4 天（p=0.004）和第 8 天（p=0.01），NLR 与死亡率相关，同时控制了这些天的 SOFA 和乳酸。
我们研究的新发现是脓毒症前七天的 NLR 与死亡率之间的关系，同时控制了脓毒症的严重程度。
