Comparison of Neutrophil-Lympocyte Ratio, Platelet-Lymphocyte Ratio with C-Reactive Protein and Erythrocyte Sedimentation Rate in Mandibular Odontogenic Space Infection Cases: A Clinical Study.

Abstract

Background and objectives: To evaluate the role of Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) in comparison with C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR) in mandibular odontogenic space infection cases.

Materials and methods: 50 patients with mandibular odontogenic space infections who fulfilled the inclusion criteria were selected. The clinical parameters such as blood pressure, pulse rate, respiratory rate, oxygen saturation level, fever, swelling, trismus, dysphagia and dyspnoea were evaluated throughout the length of hospital stay. The blood parameters such as CRP, ESR, Absolute Neutrophil Count, Absolute Lymphocyte Count and Platelet count were evaluated upon admission to hospital and were compared with the values obtained on 2nd and 5th post operative days. The NLR, PLR were derived and compared with CRP and ESR values on the day of admission, 2nd and 5th post-operative day.

Results: The results showed statistically significant differences (p > 0.05) in the values of CRP during the hospital stay of pre-admission day, 2nd and 5th post-operative day. No statistically significant differences were found in the values of NLR, PLR and ESR and on the comparison between NLR and CRP and between PLR and ESR.

Conclusion and interpretation: Among the biomarkers, CRP is a better primary biomarker and ESR is a better secondary bio-marker which are more reliable as changes in their values over the span of pre-admission day to 5th POD is more significant than other biomarkers. CRP and ESR should be incorporated as monitoring tools for managing patients with mandibular fascial space infections of odontogenic origin.