CAN NEUTROPHIL-LYMPHOCYTE RATIO PREDICT DISEASE SEVERITY AND MORTALITY IN SEPSIS AND SEPTIC SHOCK PATIENTS?

Introduction: Sepsis and septic shock are the most serious clinical conditions in intensive care units with increased mortality rates. Efforts on improving treatment modalities and survival is still the most hot topic worldwide. One of the key points is finding out a reliable and cost-effective marker that can predict prognosis. The neutrophil-lymphocyte ratio (NLR) has been shown to be associated with prognosis in various clinical situations. The aim of this study was to investigate the relationship of NLR at admission and disease severity and 28-day mortality in sepsis and septic shock patients. Materials and methods: Patients over 18 years of age admitted to Medical Intensive Care Unit (ICU) with the diagnosis of sepsis and septic shock between January 1st ,2010 and January 1st ,2016 were enrolled retrospectively. NLR at ICU admission of each patient was calculated from whole blood test results. Results: A total of 314 patients, 159 men and 155 women, were included in the study. 185 patients (58.9%) were diagnosed as sepsis and 129 patients (41.1%) as septic shock. NLR was significantly higher in the septic shock group (sepsis: 14.7, septic shock: 21.5) (p<0.05). 118 patients (37.6%) survived, and 196 (62.4%) died. While APACHE II scores (survivors: 21; non-survivors: 25) and expected mortality rates (survivors: 38%; non-survivors: 53%) were significantly different between two groups (p<0,05), no significant relationship between NLR and mortality could be detected (p>0.05). Conclusion: In our study, there was no significant relationship between NLR and mortality but, NLR was related to severity of sepsis. We suggest NLR should be used in detecting severity of sepsis besides APACHE and SOFA scores which will increase physicians' awareness during the management of therapy.