The neutrophil-lymphocyte count ratio as a diagnostic marker for bacteraemia: A systematic review and meta-analysis

Jiang, Jian; Liu, Rui; Yu, Xin; Yang, Rui; Xu, Hua; Mao, Zhi; Wang, Yongqiang

doi:10.1016/j.ajem.2018.10.057

Cited by 60 publications

(63 citation statements)

References 31 publications

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“…Numerous studies have evaluated the diagnostic and evaluative performance of the neutrophil/lymphocyte count ratio (NLCR) in various clinical conditions, such as sepsis [13], septic shock [14], bacteremia [15,16], renal, lung and colorectal carcinomas and intracranial tumors [17]. In addition, NLCR can predict the severity and outcome of CAP with higher prognostic accuracy than traditional infection markers in the emergency department [12].…”

Section: Introductionmentioning

confidence: 99%

Procalcitonin and C-reactive protein perform better than the neutrophil/lymphocyte count ratio in evaluating hospital acquired pneumonia

2020

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Background: The relationship between biomarkers and hospital-acquired pneumonia (HAP) is understudied, especially in severe cases admitted to the intensive care unit (ICU). Compared with community-acquired pneumonia (CAP), HAP might have different traits regarding biomarkers due to the previous history in hospitals. Methods: A total of 593 adult patients were enrolled in this retrospective cohort study to determine the neutrophil/lymphocyte count ratio (NLCR), procalcitonin (PCT), C-reactive protein (CRP) and serum lactate level upon admission to the ICU. According to diagnosis, patients were divided into two groups: non-infection and HAP. Discriminant analysis was performed based on better outcomes of diagnostic performance and severity evaluation. The diagnostic performance of each individual biomarker was assessed by constructing receiver operating characteristic (ROC) curves and calculating the area under each ROC curve (AUROC). Multivariable analysis was also applied to determine the most appropriate prognostic factors. Results: NLCR, PCT and CRP were markedly different between the non-infection and HAP groups. NLCR had a worse ability to discriminate severe infection (AUROC 0.626; 95% CI 0.581-0.671) than conventional markers such as CRP (0.685, 95% CI 0.641-0.730) and PCT (0.661, 95% CI 0.615-0.707). In addition, the AUROC of composite biomarkers, especially the combination of NLCR, CRP and WBC, was significantly greater than that of any single biomarker. Conclusions: NLCR was not comparable to conventional single biomarkers, such as CRP and PCT, for diagnosing or evaluating the severity of HAP. Composite biomarkers that have good accessibility, especially the combination of NLCR, CRP and WBC, could help with early diagnosis and severity evaluation.

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Section: Introductionmentioning

confidence: 99%

Procalcitonin and C-reactive protein perform better than the neutrophil/lymphocyte count ratio in evaluating hospital acquired pneumonia

2020

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“…While in clinical scenarios, PCT is more frequently used to guide antibiotic treatments. Although many reports supported NLCR as a valuable marker on severity evaluation and prognosis prediction of infectious diseases [14][15][16], our study brought up a different point of view in this aspect. Compared with conventional biomarkers such as CRP and PCT, NLCR presented to have moderate potency in diagnostic and prognostic performance of HAP.…”

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confidence: 76%

“…Numerous studies have evaluated diagnostic and evaluative performance of neutrophil lymphocyte count ration (NLCR) on various clinical conditions such as sepsis [13], septic shock [14], bacteremia [15,16], renal, lung and colorectal carcinomas and intracranial tumors [17]. Besides, NLCR has been proved to be able to predict severity and outcome of CAP with higher prognostic accuracy as 4 compared with traditional infection markers in the emergency department [12].…”

Section: Introductionmentioning

confidence: 99%

Procalcitonin and C-reactive Protein Perform Better Than Neutrophil-Lymphocyte Count Ratio on Evaluation of Hospital Acquired Pneumonia

Zheng

New

Han

2020

Preprint

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Background: The relationship between biomarkers and hospital acquired pneumonia (HAP) is under studied, especially those severe cases admitted to the intensive care unit (ICU). Compared with community acquired pneumonia (CAP), HAP might have different traits regarding biomarkers due to the previous history in the hospitals. Methods: 593 adult patients were enrolled into this retrospective cohort study to determine neutrophil-lymphocyte count ratio (NLCR), procalcitonin (PCT), C-reactive protein (CRP) and serum lactate level at the admission of ICU. According to the diagnosis, patients were divided into two groups: non-infection and HAP. Discriminant analysis was performed based on better outcomes of diagnostic performance and severity evaluation. The diagnostic performance of each individual biomarker was assessed by construction of receiver operating characteristic (ROC) curves and calculation of the area under each ROC curves (AUROC). Multivariable analysis was also applied to determine most appropriate prognostic factors. Results: NLCR, PCT and CRP between non-infection and HAP group showed remarkable differences. Because of discriminant ability of severe infection, the AUROC of NLCR (0.626; 95%CI 0.581-0.671) was not comparative with conventional markers such as CRP (0.685; 95% CI 0.641-0.730) and PCT (0.661; 95% CI 0.615-0.707). Besides, AUROC of composite biomarkers, especially the combination of NLCR, CRP and WBC, were significantly greater than the single biomarkers. Conclusions: NLCR was not comparable to conventional single biomarkers such as CRP and PCT regarding to diagnosis or severity evaluation of HAP. Composite biomarkers could prompt early diagnosis and severity evaluation with improved accessibility, especially the combination of NLCR, CRP and WBC.

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“…NLR is often used as a diagnostic and prognostic indicator of a variety of diseases and conditions. NLR can be used to accurately diagnose bacterial sepsis, bacteremia, pancreatitis, and acute appendicitis [7-9]. Higher NLRs are typically associated with poorer outcomes in non-small cell lung disease, acute pancreatitis, pulmonary embolism, cardiac disease, and a variety of cancers, including colorectal, breast, pancreatic, lung, and esophageal, to name a few [10-18].…”

Section: Introductionmentioning

confidence: 99%

Neutrophil to Lymphocyte Ratio (NLR) in captive chimpanzees (Pan troglodytes): The effects of sex, age, and rearing

Webb

Schapiro

Sherwood

et al. 2020

Preprint

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0In humans, neutrophil to lymphocyte ratio (NLR) has been used as a clinical tool in diagnosis 3 1 and/or prognosis of a variety of cancers and medical conditions, as well as in measuring 3 2 physiological stress over time. Given the close phylogenetic relationship and physical similarities 3 3 between humans and apes, NLR may similarly be a useful diagnostic tool in assessing 3 4chimpanzee health. Only one study has examined NLR in apes, reporting that NLR increased 3 5 with age and was affected by body-mass index and sex. In the current study, we examined 3 6 changes in NLR data from longitudinal health records for 443 chimpanzees in two captive 3 7 chimpanzee populations. Using these data, we analyzed intra-individual changes and inter-3 8 individual differences in NLR as a function of age, rearing history, and sex. Contrary to previous 3 9 studies in humans and the one previous study in chimpanzees, NLR values did not change over a 4 0 10-year timespan within individual chimpanzees. However, cross-sectional comparisons revealed 4 1 a significant quadratic relationship between age and NLR with the highest values during mid-life 4 2 (20-30 years of age) and the lowest values in younger and older individuals. Additionally, males 4 3 and mother-reared individuals had higher NLR than females and nursery-reared chimpanzees, 4 4respectively. Lastly, males and those with higher NLR values died at younger ages. These 4 5 findings may suggest that NLR can be used a predictor of longevity in chimpanzees. However, 4 6given the complexities of these relationships, more research is needed to determine the utility of 4 7 NLR as a diagnostic health tool for use in chimpanzees. 4 8

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The neutrophil-lymphocyte count ratio as a diagnostic marker for bacteraemia: A systematic review and meta-analysis

Cited by 60 publications

References 31 publications

Procalcitonin and C-reactive protein perform better than the neutrophil/lymphocyte count ratio in evaluating hospital acquired pneumonia

Procalcitonin and C-reactive protein perform better than the neutrophil/lymphocyte count ratio in evaluating hospital acquired pneumonia

Procalcitonin and C-reactive Protein Perform Better Than Neutrophil-Lymphocyte Count Ratio on Evaluation of Hospital Acquired Pneumonia

Neutrophil to Lymphocyte Ratio (NLR) in captive chimpanzees (Pan troglodytes): The effects of sex, age, and rearing

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