Sotianingsih Sotianingsih, S. Halim, A. Syauqi, Lidia Teresia Sinaga, Michelle Gracella
{"title":"白细胞计数和中性粒细胞/淋巴细胞比率作为脓毒症患者死亡率的预测因子","authors":"Sotianingsih Sotianingsih, S. Halim, A. Syauqi, Lidia Teresia Sinaga, Michelle Gracella","doi":"10.24293/ijcpml.v29i3.1977","DOIUrl":null,"url":null,"abstract":"Mortality in septic patients remains high despite much progress in understanding the definition, pathophysiology, and management of sepsis through sepsis bundles. Both leukocyte count and Neutrophil/Lymphocyte Ratio (NLR) are relatively inexpensive routine tests for infectious patients. Several studies of leukocytes, total neutrophils, total lymphocytes, and neutrophil/lymphocyte ratio were carried out as alternative parameters for monitoring the severity and as prognostic factors. This study aimed to analyze the difference in leukocytes and NLR based on the outcome of sepsis patients and evaluate their role in predicting death. The study was an analytic cohort of sepsis patients in intensive care at Raden Mattaher Hospital Jambi as the subjects. The research variables were survivor and non-survivor outcomes, leukocyte count, and NLR evaluation at 0, 24, 72, and 144 hours. Data were analyzed using the SPSS 21 test of difference and survival test. There was a total of 34 subjects, which consisted of a group of survivors of 14 patients (41.18%) and non-survivors of 20 patients (58.82%). At the initial diagnosis of sepsis, there was a statistically significant difference in the leukocyte count (p=0.006) and NLR (p=0.042) between survivors and non-survivors. At initial diagnosis, the leukocyte count > 15.49 X 103/µL can predict the death of sepsis patients with a Hazard Ratio (HR) of 4.001. The survival rate of patients with a leukocyte count < 15.49X103/µL and > 15.49 X 103/µL was 89.4% and 64.3%, respectively, which was statistically significant (p=0.0002). At initial diagnosis, NLR with a value of> 13.2 can predict the death of sepsis patients with HR 3.370 (p=0.001). Leukocyte count > 15.49 X 103/µL and NLR > 13.2 at the initial diagnosis of sepsis showed a risk of death of 4.001 and 3.370 times higher risk in the 144-hour evaluation. Leukocyte count > 15.49 X 103/µL and NLR > 13.2 was able to be a predictor of mortality and an indicator of a need for aggressive management in sepsis patients.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"16 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Leukocyte Count and Neutrophil/Lymphocyte Ratio as Predictor of Mortality in Sepsis Patients\",\"authors\":\"Sotianingsih Sotianingsih, S. Halim, A. Syauqi, Lidia Teresia Sinaga, Michelle Gracella\",\"doi\":\"10.24293/ijcpml.v29i3.1977\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Mortality in septic patients remains high despite much progress in understanding the definition, pathophysiology, and management of sepsis through sepsis bundles. Both leukocyte count and Neutrophil/Lymphocyte Ratio (NLR) are relatively inexpensive routine tests for infectious patients. Several studies of leukocytes, total neutrophils, total lymphocytes, and neutrophil/lymphocyte ratio were carried out as alternative parameters for monitoring the severity and as prognostic factors. This study aimed to analyze the difference in leukocytes and NLR based on the outcome of sepsis patients and evaluate their role in predicting death. The study was an analytic cohort of sepsis patients in intensive care at Raden Mattaher Hospital Jambi as the subjects. The research variables were survivor and non-survivor outcomes, leukocyte count, and NLR evaluation at 0, 24, 72, and 144 hours. Data were analyzed using the SPSS 21 test of difference and survival test. There was a total of 34 subjects, which consisted of a group of survivors of 14 patients (41.18%) and non-survivors of 20 patients (58.82%). At the initial diagnosis of sepsis, there was a statistically significant difference in the leukocyte count (p=0.006) and NLR (p=0.042) between survivors and non-survivors. At initial diagnosis, the leukocyte count > 15.49 X 103/µL can predict the death of sepsis patients with a Hazard Ratio (HR) of 4.001. The survival rate of patients with a leukocyte count < 15.49X103/µL and > 15.49 X 103/µL was 89.4% and 64.3%, respectively, which was statistically significant (p=0.0002). At initial diagnosis, NLR with a value of> 13.2 can predict the death of sepsis patients with HR 3.370 (p=0.001). Leukocyte count > 15.49 X 103/µL and NLR > 13.2 at the initial diagnosis of sepsis showed a risk of death of 4.001 and 3.370 times higher risk in the 144-hour evaluation. Leukocyte count > 15.49 X 103/µL and NLR > 13.2 was able to be a predictor of mortality and an indicator of a need for aggressive management in sepsis patients.\",\"PeriodicalId\":354500,\"journal\":{\"name\":\"Indonesian Journal of Clinical Pathology and Medical Laboratory\",\"volume\":\"16 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-07-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indonesian Journal of Clinical Pathology and Medical Laboratory\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.24293/ijcpml.v29i3.1977\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indonesian Journal of Clinical Pathology and Medical Laboratory","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.24293/ijcpml.v29i3.1977","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
脓毒症患者的死亡率仍然很高,尽管在理解脓毒症的定义、病理生理和通过脓毒症束的管理方面取得了很大进展。白细胞计数和中性粒细胞/淋巴细胞比(NLR)是感染性患者相对便宜的常规检查。白细胞、总中性粒细胞、总淋巴细胞和中性粒细胞/淋巴细胞比率作为监测严重程度和预后因素的替代参数进行了几项研究。本研究旨在分析脓毒症患者预后中白细胞和NLR的差异,并评估其在预测死亡中的作用。本研究以Jambi Raden Mattaher医院重症监护的脓毒症患者为研究对象。研究变量包括0、24、72和144小时的幸存者和非幸存者结果、白细胞计数和NLR评估。数据分析采用SPSS 21差异检验和生存检验。共34例受试者,其中存活组14例(41.18%),非存活组20例(58.82%)。在脓毒症初始诊断时,存活者与非存活者的白细胞计数(p=0.006)和NLR (p=0.042)差异有统计学意义。初诊时,白细胞计数> 15.49 X 103/µL可预测败血症患者死亡,危险比(HR)为4.001。白细胞计数< 15.49 x103 /µL和> 15.49X103/µL患者的生存率分别为89.4%和64.3%,差异有统计学意义(p=0.0002)。初诊时NLR > 13.2可预测败血症患者死亡,HR为3.370 (p=0.001)。初诊败血症时白细胞计数> 15.49 × 103/µL, NLR > 13.2, 144小时评估死亡风险增加4.001倍,死亡风险增加3.370倍。白细胞计数> 15.49 X 103/µL和NLR > 13.2可以作为脓毒症患者死亡率的预测因子和需要积极治疗的指标。
Leukocyte Count and Neutrophil/Lymphocyte Ratio as Predictor of Mortality in Sepsis Patients
Mortality in septic patients remains high despite much progress in understanding the definition, pathophysiology, and management of sepsis through sepsis bundles. Both leukocyte count and Neutrophil/Lymphocyte Ratio (NLR) are relatively inexpensive routine tests for infectious patients. Several studies of leukocytes, total neutrophils, total lymphocytes, and neutrophil/lymphocyte ratio were carried out as alternative parameters for monitoring the severity and as prognostic factors. This study aimed to analyze the difference in leukocytes and NLR based on the outcome of sepsis patients and evaluate their role in predicting death. The study was an analytic cohort of sepsis patients in intensive care at Raden Mattaher Hospital Jambi as the subjects. The research variables were survivor and non-survivor outcomes, leukocyte count, and NLR evaluation at 0, 24, 72, and 144 hours. Data were analyzed using the SPSS 21 test of difference and survival test. There was a total of 34 subjects, which consisted of a group of survivors of 14 patients (41.18%) and non-survivors of 20 patients (58.82%). At the initial diagnosis of sepsis, there was a statistically significant difference in the leukocyte count (p=0.006) and NLR (p=0.042) between survivors and non-survivors. At initial diagnosis, the leukocyte count > 15.49 X 103/µL can predict the death of sepsis patients with a Hazard Ratio (HR) of 4.001. The survival rate of patients with a leukocyte count < 15.49X103/µL and > 15.49 X 103/µL was 89.4% and 64.3%, respectively, which was statistically significant (p=0.0002). At initial diagnosis, NLR with a value of> 13.2 can predict the death of sepsis patients with HR 3.370 (p=0.001). Leukocyte count > 15.49 X 103/µL and NLR > 13.2 at the initial diagnosis of sepsis showed a risk of death of 4.001 and 3.370 times higher risk in the 144-hour evaluation. Leukocyte count > 15.49 X 103/µL and NLR > 13.2 was able to be a predictor of mortality and an indicator of a need for aggressive management in sepsis patients.