Predictive value of serum neutrophil-to-lymphocyte ratio in bronchopulmonary dysplasia: A retrospective observational study

Abstract

Aim: Our objective in this study was to evaluate the predictive significance of serum neutrophil-to-lymphocyte ratio (NLR) in bronchopulmonary dysplasia (BPD) occurrence prediction. Material and Methods: Under 32 weeks old preterm infants followed-up in our clinic between January 2015 and December 2017 were included in the study. Oxygen requirement continuing in postnatal 36th week was considered for BPD. Total blood count, C-reactive protein (CRP) and NLR in the first 24 hours of life were registered for both groups with and without BPD. The relation between BPD occurrence and risk factors was evaluated using univariate and multivariate logistic regression analysis. Results: While 27 of 54 preterm infants included in the study were BPD patients, 27of them were preterm without BPD. Average NLR values of BPD and control group were 0.80±0.49 and 0.43±0.21 in order and a statistically significant difference was detected (p=0.001). NLR (OR: 0.042; 95% CI: 0.004-0.413; p=0.001) was determined as independent risk factor for BPD occurrence in logistic regression analysis. NLR cut-off value was 0.64, sensitivity was 57.7%, specificity was 81.5% and the area below the curve was 0.737 (95% CI: 0.601-0.873) according to the ROC curve. A positively weak (r=0.26) statistically significant relation was detected among NLR and oxygen duration in Pearson correlation analysis (p=0.05). Conclusion: NLR can be a promising device for predicting BPD patients in the first 24 hours. It was demonstrated that BPD could occur in premature infants with NLR>0.64.