Neutrophil-to-lymphocyte ratio as marker of organ dysfunction severity in patients with sepsis in the intensive care unit: An observational study

Abstract

Background: The neutrophil-to-lymphocyte ratio (NLR) is an easily computable parameter and is believed to accurately determine the disease-related organ dysfunction severity and prognosis in sepsis. Methods: This study aimed at identifying the role of NLR in predicting organ dysfunction severity and prognosis in patients with sepsis requiring admission to an intensive care unit (ICU). In this observational study, NLR and Sequential Organ Failure Assessment (SOFA) scores were calculated at the time of admission in patients with sepsis. Patients were followed until discharge or death. Results: Fifty five ICU patients with sepsis were enrolled. The mean NLR and SOFA scores for the total study cohort were 7.91 ± 3.01 and 8.76 ± 3.16, respectively. The corresponding values for those in septic shock were 8.96 ± 2.80 and 9.94 ± 3.78. A positive correlation was observed between SOFA score and NLR in all patients (r = 0.5584, P < 0.001); patients with sepsis only (r = 0.4821, P = 0.002); and patients with sepsis and shock (r = 0.6321, P = 0.004). In the total population, mean NLR was significantly higher among non-survivors, compared to survivors (9.17±3.1 vs. 7.09±2.7 ; P = 0.0054). Conclusions: NLR at admission shows a good correlation with the organ dysfunction severity in sepsis and may be used as a prognostic marker, thereby guiding the intensification of management.

Keywords

• intensive care unit
• neutrophil-to-lymphocyte ratio
• sepsis
• septic shock
• sequential organ failure assessment score