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Role Neutrophil to Lymphocyte Ratio on Admission as a Predictor of in Hospital Mortality in Septic Patients

Fazal Ur Rehman*, Asadullah Khan, Madiha Iqbal, Bakhtawar Jamal Rind, Syed Ahsan, Zain Mushtaq and Naureen Akber Ali

Background: Sepsis has high mortality globally. The key factor in decreasing the mortality is early diagnosis and the initiation of appropriate treatment within hours. Various biomarkers are in use for timely diagnosis but none is without limitation. It’s imperative to predict the mortality early in order to sensitize those involved in the care. We studied Neutrophil to Lymphocyte Ratio (NLR) as a prognostic marker in sepsis.

Methodology: It was a retrospective study, conducted at Aga khan university hospital from 30th November 2020 to 31st March 2021. Data was calculated from patient medical record after approval from ERC. Multiple linear regression technique was used to determine the association between increased NLR with mortality.

Results: Our study included 168 patients. The median (IQR) NLR of the patients was 10.4 (13.4). The mean SOFA score of the patients was noted to be 5.7 ± 2.9, mortality was reported in 26.1% (n=44) patients. Multiple linear regression showed NLR increased by 2.0 times with every mg/dl increased in average total bilirubin level (95% CI: 0.4-3.2), and by 1 times with every one unit increase in SOFA score (95% CI: 0.1-1.5). However, there was no significant association found between NLR and mortality rate.

Conclusion: NLR is an effective marker for predicting sepsis; however, its role in predicting mortality is yet to be established.