Neutrophil-to-Lymphocyte Ratio and Outpatient Management of Low-Risk Acute Pulmonary Embolism

Abstract

Purpose: Low-risk pulmonary thromboembolism (PTE) outpatient management has been described recently. The blood neutrophil/lymphocyte ratio (NLR) has been shown to be a useful marker of cardiovascular disease and an independent predictor of cardiac mortality. The predictive value of NLR in predicting mortality of low-risk PTE was evaluated in this study. Materials and Methods: The total of 168 patients with definite pulmonary embolism diagnosed by computed tomography angiography whose on-admission simplified Pulmonary Embolism Severity Index (PESI) score was zero enrolled in this study. The survival rate of patients according to their NLR was evaluated. Results: During 12 months' follow-up period, eight patients (4.7%) died. None of the patients with an NLR of <3.2 died during the follow-up. The median values of NLR in the nonsurvivor and survivor groups were 9.2 ± 3.03 (2–29.5) and 4.69 ± 0.43 (0.8–24.5), respectively. NLR values were significantly higher in nonsurvivors compared to survivors (P = 0.043). Conclusion: This study suggests that patients with zero PESI score and NLR <3.2 could be managed patiently with good results.

Keywords

• low risk
• neutrophil/lymphocyte ratio
• outcome
• pulmonary embolism
• simplified pulmonary embolism severity index