The neutrophil-lymphocyte count ratio in patients with hospital-acquired pneumonia

Abstract

Introduction: Hospital-acquired pneumonia includes ventilator-associated pneumonia (VAP), postoperative pneumonia, and pneumonia that develops in unventilated hospitalized inpatients. lying more than 48 hours in hospital. Aim: 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 hospital-acquired pneumonia (CAP). Method: Consecutive adult patients were retrospectively studied during one year. 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 103 patients diagnosed with HAP. The mean age of the patients was 67.4 ± 18.0 years. 92.23% (95/103) were treated in department, while 7.77% patients were admitted to the Intensive Care Unit (ICU). The NLCR was increased in all patients, predicted adverse medical outcome and consistently increased as the CURB-65 score advanced. 3,88% (4/103) patients of the study died in ICU, ventilator associated. NLCR levels were significantly higher in non-survivors (27.3 ± 18.8) than in survivors (10.0 ± 11.4). The receiver-operating characteristic (ROC) curve for NLCR predicting mortality showed an area under the curve (AUC) of 0.812. 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: Using NLCR in the HAP predicts severity and outcome of HAP with a higher prognostic accuracy as compared with traditional infection markers.