• Kim Westerdijk, Koen S Simons, Marissa Zegers, Peter C Wever, Peter Pickkers, and de Jager Cornelis P C CPC Department of Intensive Care Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands..
• Department of Intensive Care Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
• Plos One. 2019 Jan 1; 14 (2): e0212861.

BackgroundEarly diagnosis and treatment has proven to be of utmost importance in the outcome of sepsis patients. We compared the accuracy of the neutrophil-lymphocyte count ratio (NLCR) to conventional inflammatory markers in patients admitted to the Intensive Care Unit (ICU).MethodsWe performed a retrospective cohort study consisting of 276 ICU patients with sepsis and 388 ICU patients without sepsis. We compared the NLCR as well as C-reactive protein (CRP) level, procalcitonin (PCT) level, white blood cell (WBC) count, neutrophil count and lymphocyte count on ICU admission between sepsis and non-sepsis ICU patients. To evaluate the sensitivity and specificity, we constructed receiver operating characteristics (ROC) curves.ResultsSignificant differences in NLCR values were observed between sepsis and non-sepsis patients (15.3 [10.8-38.2] (median [interquartile range] vs. 9.3 [6.2-14.5]; P<0.001), as well as for CRP level, PCT level and lymphocyte count. The area under the ROC curve (AUROC) of the NLCR was 0.66 (95%CI = 0.62-0.71). AUROC was significantly higher for CRP and PCT level with AUROC's of 0.89 (95%CI 0.87-0.92) and 0.88 (95%CI 0.86-0.91) respectively.ConclusionsThe NLCR is less suitable than conventional inflammatory markers CRP and PCT to detect the presence of sepsis in ICU patients.Trial RegistrationClinicalTrials.gov NCT01274819.

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