Neutrofil-Lymphocyte Ratio Against Pulmonary TB Retreatment at Sanjiwani Gianyar Regional Hospital, 2020-2022

Abstract

Background: Tuberculosis (TB) is one of the main causes of death and the highest cause of death caused by infection. Distinguishing between pulmonary TB that has been cured and completed treatment from retreatment TB based only on history, physical examination, laboratory examination and radiological findings is often difficult because pulmonary TB is often non-specific and the sensitivity of sputum microscopic examination for BTA bacteria is 50-60%. Neutrophil Lymphocyte Ratio (NLR) is considered to have a stronger discriminatory ability in predicting bacteremia than discrimination based on neutrophilia or lymphocytopenia alone. Method: This research uses analytical research methods with a case-control design because measurements are carried out at the same time. This study uses secondary data obtained from the medical records of patients who experienced TB in the period from January 2020 to May 2022. Results: In this study, the average age of cases was 48 ± 17 years and that of controls was 52 ± 14 years. Based on the receiver operating characteristics (ROC) curve, it was found that the best NLR cut-off was 3.2 with a sensitivity of 92% and a specificity of 32%. Based on chi-square analysis, it was found that the NLR cut-off of 3.2 was significantly correlated with the incidence of retreatment with P=0.009. Conclusion: The neutrophil-lymphocyte ratio (NLR) with a cut-off of 3.2 can be used as a useful indicator in tuberculosis (TB) retreatment.