Study On The Relationship Between Neutrophil/Lymphocyte Ratio And Serum Albumin In Predicting The Prognosis Of Septic Shock

Objective: To evaluate the ratio of neutrophils to lymphocytes and the parameters of serum albumin in patients with septic shock in the department of emergency and critical medicine in our hospital,and to explore the reference value of compound laboratory indexes in the adverse clinical outcome of patients with septic shock.Methods: A retrospective study was conducted on ICU and EICU,82 patients diagnosed as septic shock in Yijishan Hospital of the first affiliated Hospital of Southern Anhui Medical College from August 2019 to August 2020.Systematic notes were made on the general clinical data of the selected patients at the beginning of admission(body temperature,respiratory rate,heart rate,blood pressure,basic diseases,site of infection,etc.).And the relevant laboratory indexes in the first 24 hours,such as white blood cell count,ALB,neutrophil count,hs-CRP,lymphocyte count,bilirubin,PCT,Lac,serum creatinine,24-hour urine volume and so on.All cases were divided into survival group(n=31)and death group(n=51)according to the prognosis of 28 days.The ratio of neutrophil to lymphocyte count was calculated and statistically analyzed by IBMSPSS21.0,Med Cal and Graphpad Prism software.the receiver working curve(ROC curve)was used to analyze the reference value of NLR combined with ALB in judging the adverse clinical outcome of patients with septic shock.Results: This study finally included 82 effective clinical data,and the case fatality rate was 62.20%.According to the final outcome,the patients were divided into survival group and death group.The value of NLR{24.25(13.67～59.50},Lac{5.00(2.40～7.70)},SOFA score(13.35±3.68)PCT{88(54.10～106.66)},and hs-CRP(164.82±70.86)in the death group were significantly higher than those in the survival group,and the lymphocyte count and ALB level in the death group were significantly lower than those in the survival group(P < 0.05).The lymphocyte count(0.65±0.41)and ALB level(21.50±5.78)in the death group were lower than those in the survival group,and the difference was statistically significant(P < 0.05).The Spearman correlation analysis between the severity of the disease and NLR,ALB,NLR combined with ALB showed that there was a negative correlation between ALB and the poor prognosis of septic shock.NLR and NLR combined with ALB were positively correlated with the severity of septic shock.The area under the ROC curve of the predictive value of NLR,ALB and NLR combined with ALB for adverse terminal outcome was 0.668(0.555～0.768)、0.873(0.782～0.937)、0.892(0.804～0.950)respectively.Conclusion:1.There were significant differences in NLR and ALB among septic shock patients with different survival outcomes.2.NLR,ALB,NLR and ALB are reliable predictors to evaluate the severity of septic shock and early predict the mortality of septic shock patients.The application value of NLR and ALB is better than that of NLR and ALB alone.