An Albumin, Neutrophil, and Lymphocyte-Related Risk Estimation Tool in Hospitalised Patients

Area of Science:

• Clinical Biochemistry
• Hematology
• Medical Diagnostics

Background:

• The neutrophil-to-lymphocyte ratio (NLR) is a recognized prognostic marker for various clinical conditions.
• Albumin levels, a nutritional marker, may offer additional predictive value when combined with inflammatory markers.

Purpose of the Study:

• To evaluate the predictive performance of the neutrophils to albumin and lymphocytes ratio (NALR) against the NLR.
• To assess the utility of NALR in predicting adverse outcomes in hospitalized patients, including organ system decomposition, prolonged hospital stays, and mortality.

Main Methods:

• An observational study involving 270 hospitalized adult patients.
• Patients were categorized into groups based on outcomes (better vs. poorer).
• Binary logistic, ROC, and sensitivity analyses were employed to compare NALR and NLR predictive capabilities.

Main Results:

• NALR demonstrated a significantly higher area under the ROC curve (0.808) compared to NLR (0.667).
• NALR exhibited superior sensitivity (86.7%) and specificity (70.73%) at its optimal threshold (1.5) versus NLR (73.4% sensitivity, 70.73% specificity at threshold 5.37).
• Poorer outcomes were associated with significantly longer hospital stays.

Conclusions:

• The NALR shows enhanced predictive performance, sensitivity, and correlation compared to the NLR.
• Both NALR and NLR can aid clinicians in prioritizing care for hospitalized patients with unfavorable prognoses.