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| The Value of Neutrophil/lymphocyte Ratio in Assessing the Severity and Prognosis of Ventilator-associated Pneumonia |
| XIE Xiaobing, GAO Yun, LIU Kai, et al |
| People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Wulumuqi 830001, China |
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Abstract Objective: To evaluate the value of neutrophil/lymphocyte ratio in assessing the severity and prognosis of ventilator-associated pneumonia (VAP). Methods: The clinical data of 210 patients with VAP who were admitted to our hospital from December 2014 to December 2018 were analysized retrospectively. According to the acute physiology and chronic health evaluation II (APACHE II) within 24 hours, the patients were divided into low risk group (APACHE II score <10, 67 cases), intermediate risk group (10≤APACHE II score≤20, 70 cases) and high-risk group (APACHE II score > 20, 73 cases). According to clinical prognosis, they were divided into survival group (159 cases) and death group (51 cases). The clinical data of the patients in different groups were recorded including APACHE II score, clinical pulmonary infection score (CPIS), sepsis related organ failure assessment (SOFA), neutrophil (NEU), (lymphocyte (LYM), NLR, procalcitonin, (PCT), hypersensitive C reactive protein (hs-CRP). The logistics regression, correlation analysis and receiver operator characteristic curve (ROC) were used to analyze the data of different groups. Results: The difference of NLR levels among different severity groups was statistically significant (P<0.05), which high-risk group was the highest, intermediate risk group was the second, and low risk group was the lowest. The NLR level in the death group was significantly higher than that in the surviving group, the difference was statistically significant (P<0.05). The multivariate logistic regression analysis showed that NLR, prealbumin (PA), APACHE II, CPIS, SOFA were independent risk factors for poor prognosis. The correlation analsis showed that NLR level in the death group were positively correlated with APACHE II score, CPIS score, and SOFA score (r1=0.842, P1<0.001; r2=0.805, P2<0.001; r3=0.901, P3<0.001). There was a significant negative correlation between NLR and PA levels (r= -7.047, P<0.001). ROC curves analysis showed that the area under curve of NLR level was 0.833 (95%CI:0.735~0.931), and threshold (OOP) was 9.52, which had 81.58% sensitivity and 81.58% specificity in predicting poor prognosis. Conclusions: The NLR level has a high predictive value for assessing the severity and prognosis of patients with VAP, which is worthy of clinical promotion.
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2020, Vol. 26 
