Predictive Value Of Neutrophil-to-lymphocyte Count Ratio In Patients With Community-Acquired Pneumonia

Objective To investigate the predictive value of neutrophil-lymphocyte count ratio(NLCR) in the patients with community acquired pneumonia.Methods A retrospective cohort study was conducted from June 2012 to December 2014 in Tianjin Medical University General Hospital.218 patients with CAP were admitted to the emergency ward.Clinical data were retrospectively compared. Collecting the basic situation(with agr,sex,combined basic diseases),laboratory examination(the white blood cell(WBC), neutrophil-lymphocyte count ratio(NLCR), procalcitonin(PCT), c-reactive protein(CRP),hepatic and renal function were measuered on day 1 after admission).According to NLCR point,all patients were divided into different group(NLCR≥10 or NLCR<10) respectively. Data between two groups were compared,the relationvship between NLCR,WBC,PCT and CURB-65 scores was analysised,and statistical analysis was carried out on the CAP patients death value.Results In this study,218 patients with CAP were collected,including 96 males and 122 females with an average age of(60.2±23.6)years(range from 26-87 years).128 patients were in NLCR≥10 group, including 58 males and 70 females with an average age of(58.4 ± 19.6)years(range from 26-82 years). 90 patients were in NLCR<10 group, including 38 males and 52 females with an average age of(61.2±21.6)years(range from 28-87 years).The levels of PCT in NLCR≥10 group(8.24±2.39)were higher significantly than that in NLCR<10 group(3.21±1.84)(P<0.01).The levels of CRP and WBC in NLCR≥10 group and NLCR<10 group were no significantly difference(P>0.05).The levels of NLCR in germiculture positive group(6.32±2.76)were higher signifacantly than that in the germiculture negative group(3.87±2.54),the comparative difference was statistically significant(P<0.05). According to CURB-65 scores, the levels of NLCR in high risk group(8.47±3.15)were higher significantly than that in low risk group(5.39±2.83)(P<0.05).The results of correlation analysis between the NLCR and each index were as follows: the correlation coefficient between the NLR and the WBC was r= 0.103, P > 0.05; between the NLCR and the PCT was r = 0.891, P < 0.01; between the NLCR and CURB- 65 was r = 0.673, P < 0.01.The correlation between NLCR and WBC was not strong,but with the PCT and the CURB-65 were strong.Through the ROC analysis,we found that the NLCR was an effective predictive index of death CAP patients,Conclusion Neutrophil-lymphocyte count ratio can be used for clinical assessment of disease severity in CAP patients, and also have some clinical significance for forecasting death of the patients with CAP.