The Neutrophil-Lymphocyte Count Ratio in Patients with Community-Acquired Pneumonia

PLoS One

Tom van der Poll¹  Eugenie F. A. Gemen²  Ron Kusters²  Robert J. F. Laheij³  Cornelis P. C. de Jager³  Peter C. Wever⁴  Arianne B. van Gageldonk-Lafeber⁵ 

[1] Center of Infection and Immunity Amsterdam and Center of Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, The Netherlands;Department of Clinical Chemistry and Hematology, Jeroen Bosch Ziekenhuis, ’s-Hertogenbosch, The Netherlands;Department of Emergency Medicine and Intensive Care, Jeroen Bosch Ziekenhuis, ’s-Hertogenbosch, The Netherlands;Department of Medical Microbiology and Infection Control, Jeroen Bosch Ziekenhuis, ’s-Hertogenbosch, The Netherlands;National Institute for Public Health and the Environment, Bilthoven, The Netherlands

关键词: Neutrophils;    Lymphocytes;    Critical care and emergency medicine;    Blood counts;    Pneumonia;    Antibiotics;    Intensive care units;    Blood;   

DOI  :  10.1371/journal.pone.0046561

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Study Objective The neutrophil-lymphocyte count ratio (NLCR) has been identified as a predictor of bacteremia in medical emergencies. The aim of this study was to investigate the value of the NLCR in patients with community-acquired pneumonia (CAP). Methods and Results Consecutive adult patients were prospectively studied. Pneumonia severity (CURB-65 score), clinical characteristics, complications and outcomes were related to the NLCR and compared with C-reactive protein (CRP), neutrophil count, white blood cell (WBC) count. The study cohort consisted of 395 patients diagnosed with CAP. The mean age of the patients was 63.4±16.0 years. 87.6% (346/395) of the patients required hospital admission, 7.8% (31/395) patients were admitted to the Intensive Care Unit (ICU) and 5.8% (23/395) patients of the study cohort died. The NLCR was increased in all patients, predicted adverse medical outcome and consistently increased as the CURB-65 score advanced. NLCR levels (mean ± SD) were significantly higher in non-survivors (23.3±16.8) than in survivors (13.0±11.4). The receiver-operating characteristic (ROC) curve for NLCR predicting mortality showed an area under the curve (AUC) of 0.701. This was better than the AUC for the neutrophil count, WBC count, lymphocyte count and CRP level (0.681, 0.672, 0.630 and 0.565, respectively). Conclusion Admission NLCR at the emergency department predicts severity and outcome of CAP with a higher prognostic accuracy as compared with traditional infection markers.

【 授权许可】

CC BY