J Korean Geriatr Soc.  2013 Dec;17(4):213-218. 10.4235/jkgs.2013.17.4.213.

The Value of Neutrophil-Lymphocyte Count Ratio for Disease Severity in Nursing Home Acquired Pneumonia Patients

• Rhee DY
• Park SH
• Choi HJ
• Kwon MK
• Cho DH

• KMID: 2188229
• DOI: http://doi.org/10.4235/jkgs.2013.17.4.213

Abstract

BACKGROUND
We evaluated the value of neutrophil-lymphocyte count ratio (NLCR) in patients admitted to the Emergency Department (ED) with suspected nursing home acquired pneumonia (NHAP).
METHODS
From May 2011 to January 2013, 116 patients admitted to the ED with suspected NHAP were retrospectively studied. The clinical characteristics, C-reactive protein (CRP), white blood cell count, neutrophil count, lymphocyte count, and NLCR were assessed. CURB-65 score was used to calculate disease severity. General ward or intensive care unit (ICU) admissions, and 72-hour and 30-day mortality for each infection marker was assessed.
RESULTS
The 116 patients had a median age of 77 years. As the CURB-65 score increased from 0-1 (low risk), to 2-3 (moderate risk), and to 4-5 (high risk), the NLCR consistently increased (mean, 6.9, 8.89, and 16.22, respectively). The difference between the moderate and high risk groups was significant (p=0.008). The NLCR (mean+/-standard deviation) was high in patients with NHAP (10.28+/-8.81) and increased even more for patients admitted to the ICU (15.69+/-14.81) or who died within 72-hour (15.63+/-9.57). NLCR showed the trend of higher value in ICU admission (p=0.072), and CRP was significantly different between ICU and general ward admission (p=0.007).
CONCLUSION
NLCR at ED admission correlated with NHAP severity and was comparable to the traditional infection marker. NLCR can be assessed simply and added to the assessment tools to determine the severity of pneumonia during ED admission.

Keyword

Nursing homes; Aged; Pneumonia; Severity assessment

MeSH Terms

C-Reactive Protein
Emergencies
Humans
Intensive Care Units
Leukocyte Count
Lymphocyte Count
Mortality
Neutrophils
Nursing Homes*
Nursing*
Patients' Rooms
Pneumonia*
Retrospective Studies
C-Reactive Protein