Clinical Significance Of NLR Value In Predicting The Incidence Of Organ Dysfunction And Mortality In Patients With Sepsis In Early Stage

Objective: To determine the clinical significance of neutrophil lymphocyte ratio(NLR)in predicting the incidence of organ dysfunction and 28-day mortality in septic patients.Methods: We enrolled adult patients with sepsis who presented to the Intensive Care Unit of the First Affiliated Hospital of China Medical University from January 2017 to December 2019.NLR value was collected at 24 h,48h and 72 h after sepsis diagnosis.The primary outcome of the study was the incidence of sepsis related acute kidney injury(AKI),acute respiratory distress syndrome(ARDS),disseminated intravascular coaglation(DIC)and acute liver failure(ALF).The secondary end point was 28 day in-hospital mortality.Logistic regression was used to analyze the correlation between NLR valuse and organ dysfunction as wel as 28-day mortality in septic patients;receiver operating characteristic curve(ROC)was drawn,and the predictive value of NLR for organ dysfunction and 28 day mortality in patients with sepsis was evaluated according to area under ROC curve(AUC).Results: A total of 714 patients with sepsis were included in the final statistical analysis.There was no significant difference in NLR values(at 24 h,48h,72h)between patients with organ dysfunction(AKI,ARDS,DIC,ALF)and patients without organ dysfunction(P > 0.05).Regression analysis showed that there was no significant correlation between 24 h NLR and 28 day mortality(P > 0.05),but there was significant correlation between 48 h and 72 h NLR and 28 day mortality(P < 0.05),which was an independent risk factor in predicting 28 day mortality.ROC curve showed that the AUC of predicting 28 day mortality by NLR was 0.598 at 48 hours after diagnosis of sepsis.When NLR = 10.1,the sensitivity and specificity of predicting mortality were 0.752 and0.58 respectively.The AUC of NLR for predicting 28 day mortality was 0.595 at 72 hours.When NLR = 9.24,the sensitivity and specificity were 0.753 and 0.599,respectively.Conclusion: NLR value can not predict the occurrence of AKI,ARDS,DIC or ALF in the early stage of sepsis,and its clinical application needs to be further explored.NLR has a certain clinical value in predicting 28 day mortality of patients with sepsis,but its predictive efficiency is low,which needs further research and verification.