Comparison of neutrophils-lymphocytes ratio and procalcitonin parameters in sepsis patient treated in intensive care unit Dr. Wahidin hospital, Makassar, Indonesia

Abstract

Neutrophils-lymphocytes ratio (NLR) is regarded as a cheap, simple and promising parameter to predict sepsis severity. This study was aimed to compare NLR and procalcitonin (PCT) parameters and its correlation with acute physiology and chronic health evaluation (APACHE) II scoring system in sepsis and severe patients. This retrospective study investigated 65 sepsis patients data in the medical record that been treated in Intensive Care Unit (ICU) in the last 2015 at Dr. Wahidin Sudirohusodo Hospital Makassar. Data collected including neutrophil, lymphocytes, PCT and the APACHE II score. Based on clinical finding and the dependency to vasopressor, the patients were divided into sepsis and severe sepsis groups. The NLR, PCT and APACHE II scores in sepsis and severe sepsis were compared, the cut off point for NLR and PCT were determined and the sensitivity and specificity were calculated. Procalcitonin level was significantly different in sepsis and severe sepsis groups (p<0.001), the difference was not seen for NLR. The Cut off Point (COP) to distinguish between sepsis and severe sepsis for NLR was 9.05 with sensitivity and specificity 59.6 and 50.0%, respectively. For PCT it was 2.89 with sensitivity and specificity 98.2 and 75.0%, respectively. There was a significant positive correlation between APACHE II score with NLR (p = 0.036) and with PCT (p = 0.027). Procalcitoninis superior than NLR in distinguishing sepsis and severe sepsis, however, since a positive correlation found between APACHE II score with NLR and with PCT, NLR can be used as parameter to predict the severity of sepsis in the hospital with limited laboratory facilities.

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