Authors

YUSUF SAVRAN1 TUGCE MENGI2, BARIS YILMAZ3, MURAT E. TOKUR4, BEGUM ERGAN5, ERDEM YAKA6, BILGIN COMERT7

Departments

1Department of Internal Medicine, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey - 2Department of Neurology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey - 3Department of Pulmonology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey - 4Department of Anesthesiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey - 5Department of Pulmonology and Intensive Care, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey - 6Department of Neurology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey - 7Department of Internal Medicine and Intensive Care, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey

Abstract

Introduction: Sepsis and septic shock are the most serious clinical conditions in intensive care units with increased mortality rates. Efforts on improving treatment modalities and survival is still the most hot topic worldwide. One of the key points is finding out a reliable and cost-effective marker that can predict prognosis. The neutrophil-lymphocyte ratio (NLR) has been shown to be associ- ated with prognosis in various clinical situations. The aim of this study was to investigate the relationship of NLR at admission and disease severity and 28-day mortality in sepsis and septic shock patients.

Materials and methods: Patients over 18 years of age admitted to Medical Intensive Care Unit (ICU) with the diagnosis of sepsis and septic shock between January 1st ,2010 and January 1st ,2016 were enrolled retrospectively. NLR at ICU admission of each patient was calculated from whole blood test results.

Results: A total of 314 patients, 159 men and 155 women, were included in the study. 185 patients (58.9%) were diagnosed as sepsis and 129 patients (41.1%) as septic shock. NLR was significantly higher in the septic shock group (sepsis: 14.7, septic shock: 21.5) (p<0.05). 118 patients (37.6%) survived, and 196 (62.4%) died. While APACHE II scores (survivors: 21; non-survivors: 25) and expected mortality rates (survivors: 38%; non-survivors: 53%) were significantly different between two groups (p<0,05), no sig- nificant relationship between NLR and mortality could be detected (p>0.05).

Conclusion: In our study, there was no significant relationship between NLR and mortality but, NLR was related to severity of sepsis. We suggest NLR should be used in detecting severity of sepsis besides APACHE and SOFA scores which will increase physi- cians’ awareness during the management of therapy.

Keywords

critical care, mortality, neutrophil-lymphocyte ratio, sepsis, septic shock, severity

DOI:

10.19193/0393-6384_2018_3_134