Strong Positive Correlation between Neutrophil-to-lymphocyte Ratio and C-reactive Protein in Early Onset Sepsis

Background and Purpose Guillain-Barre syndrome (GBS) is a common cause of inflammation-related acute flaccid paralysis, and is characterized by acute onset, rapid progression, and symmetrical weakness. GBS is an emergency with high morbidity and long-term disability rates. It is important to determine the prognostic factors for GBS in order to improve the disease outcomes. This study aimed to identify the correlation between the neutrophil-to-lymphocyte ratio (NLR) on day 1 of hospitalization (D1) and motor deterioration in GBS patients. Methods This observational analytical study applied a cross-sectional analysis to the medical records of GBS patients who were hospitalized at Dr. Soetomo General Hospital Surabaya from January 2018 to March 2020. The analysis used the chi-square bivariate test, multivariate analysis with logistic regression, and correlation analysis with the Spearman test. Results The study included 61 subjects. Statistical tests showed that there was no correlation between NLR and changes in the Medical Research Council sum scores (ΔMRC sum scores) during D1–D3, D1–D7, D1–D14, and D1 to the day of discharge ( p >0.05). There was a significant correlation between NLR and the Erasmus GBS outcome score (EGOS) ( p =0.006). NLR values differed significantly within each treatment group ( p =0.001). Therefore, a subanalysis within each treatment group was conducted, which revealed a significant negative correlation ( p <0.05) between NLR and the ΔMRC sum score during D1–D14 in the group treated without immunotherapy. Conclusions There was no correlation between NLR and motor deterioration in patients with GBS during hospitalization. However, NLR was significantly correlated with EGOS, and there was a negative correlation between NLR and motor deterioration during D1–D14 in GBS patients treated without immunotherapy.

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“…Inflammatory processes that attack the nervous system can cause muscle weaknesses in GBS patients, as represented by the MRC sum score. 25 26 …”

Section: Discussionmentioning

confidence: 99%

Correlation Between Neutrophil-to-Lymphocyte Ratio and Motoric Deterioration in Patients With Guillain-Barre Syndrome

et al. 2022

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“…20 Penelitian pada pasien sepsis neonatus di Bandung juga melaporkan adanya korelasi positif antara NLCR dan CRP. 21 Skor PELOD-2 adalah sistem penilaian yang sering digunakan untuk menggambarkan disfungsi organ multipel. Peningkatan skor PELOD-2 berkaitan dengan efek kumulatif disfungsi organ dan menggambarkan tingkat keparahan sepsis.…”

Section: Pembahasanunclassified

Korelasi Positif antara Neutrophil Lymphocyte Count Ratio dan C-Reactive Protein pada Pasien Sepsis Anak

Anwary

Hakim

Setiabudi

2021

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Latar belakang. Sepsis merupakan penyebab utama morbiditas dan mortalitas utama pada anak di seluruh dunia. C-reactive protein (CRP) merupakan penanda infeksi yang paling banyak digunakan, tetapi parameter tersebut terkendala tingkat sensitivitas, spesifisitas, ketersediaan alat, dan biaya. Neutrophil-lymphocyte Count Ratio (NLCR) merupakan pemeriksaan yang mudah dan murah, serta banyak digunakan sebagai penanda diagnostik pada berbagai proses inflamasi.Tujuan. Menganalisis korelasi antara NLCR dan CRP pada pasien sepsis anak.Metode. Studi analitik observasional menggunakan data sekunder dari register sepsis anak di RSUP Dr. Hasan Sadikin Bandung periode Januari 2019–Desember 2019. Pengambilan data berupa karakteristik pasien, nilai NLCR, dan CRP, didapatkan data tidak berdistribusi normal( uji Kolmogorov-Smirnov) maka analisis korelasi dilakukan menggunakan uji Rank Spearman dengan nilai kemaknaan p<0,05.Hasil. Sebanyak 80 subjek memenuhi kriteria inklusi. Median nilai NLCR subjek 2,98 (rentang 0,12-19,38) dan nilai median CRP subjek 2,44 (rentang 0,01-34,04) Nilai NLCR memiliki korelasi bermakna dengan CRP (r=0,310; p=0,005). Kesimpulan. Terdapat korelasi positif yang bermakna antara neutrophil-lymphocyte count ratio dengan CRP pada pasien sepsis anak.

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Meta-analysis of the role of neutrophil to lymphocyte ratio in neonatal sepsis

Chen,

Yasrebinia,

Ghaedi

et al. 2023

BMC Infect Dis

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Introduction The neutrophil to lymphocyte ratio (NLR), an inflammatory biomarker, measures innate-adaptive immune system balance. In this systematic review and meta-analysis, we aim to analyze the current literature to evaluate the diagnostic role of NLR in neonatal sepsis. Methods PubMed, Web of Science, and Scopus were used to conduct a systematic search for relevant publications published before May 14, 2022. Results Thirty studies, including 2328 neonates with sepsis and 1800 neonates in the control group, were included in our meta-analysis. The results indicated that NLR is higher in neonates with sepsis compared to healthy controls (SMD = 1.81, 95% CI = 1.14–2.48, P-value < 0.001) in either prospective (SMD = 2.38, 95% CI = 1.40–3.35, P-value < 0.001) or retrospective studies (SMD = 0.87, 95% CI = 0.63–1.12, P-value < 0.001) with a pooled sensitivity of 79% (95% CI = 62–90%), and a pooled specificity of 91% (95% CI = 73–97%). Also, we found that NLR is higher in neonates with sepsis compared to those who were suspected of sepsis but eventually had negative blood cultures (SMD =1.99, 95% CI = 0.76–3.22, P-value = 0.002) with a pooled sensitivity of 0.79% (95% CI = 0.69–0.86%), and a pooled specificity of 73% (95% CI = 54–85%). In addition, neonates with sepsis had elevated levels of NLR compared to other ICU admitted neonates (SMD = 0.73, 95% CI = 0.63–0.84, P < 0.001). The pooled sensitivity was 0.65 (95% CI, 0.55–0.80), and the pooled specificity was 0.80 (95% CI, 0.68–0.88). Conclusion Our findings support NLR as a promising biomarker that can be readily integrated into clinical settings to aid in diagnosing neonatal sepsis. As evidenced by our results, restoring balance to the innate and adaptive immune system may serve as attractive therapeutic targets. Theoretically, a reduction in NLR values could be used to measure therapeutic efficacy, reflecting the restoration of balance within these systems.

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Strong Positive Correlation between Neutrophil-to-lymphocyte Ratio and C-reactive Protein in Early Onset Sepsis

Cited by 3 publications

References 17 publications

Correlation Between Neutrophil-to-Lymphocyte Ratio and Motoric Deterioration in Patients With Guillain-Barre Syndrome

Correlation Between Neutrophil-to-Lymphocyte Ratio and Motoric Deterioration in Patients With Guillain-Barre Syndrome

Korelasi Positif antara Neutrophil Lymphocyte Count Ratio dan C-Reactive Protein pada Pasien Sepsis Anak

Meta-analysis of the role of neutrophil to lymphocyte ratio in neonatal sepsis

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