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Neutrophil Isolation and Analysis to Determine their Role in Lymphoma Cell Sensitivity to Therapeutic Agents
Published on: March 25, 2016
Neutrophil-to-Lymphocyte Ratio as a Prognostic Marker for Hospital-Acquired Infections in Neurosurgical Patients
Renata Jabłońska1, Robert Ślusarz1, Magdalena Zając2
1Faculty of Health Science, Department of Neurological and Neurosurgical Nursing, Department of Interventional Nursing, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland.
Purpose:
The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory marker associated with adverse outcomes, including hospital-acquired infections (HAIs) and mortality. This study evaluated its prognostic value in neurosurgical patients.
Patients And Methods:
In this retrospective study of 5474 neurosurgical admissions, 147 HAIs occurred in 93 patients (HAIs group). A control group of 181 patients was matched for age, sex, and mortality status. Clinical (Nutrition Risk Screening 2002 [NRS-2002], Glasgow Coma Scale [GCS]) and demographic variables were compared with NLR. Survival was analyzed using Kaplan-Meier curves. Statistical tests included chi-square, Mann-Whitney, ANOVA, log-rank.
Results:
Patients with HAIs (58.1% male, mean age 63.7 ± 15.5 years) more often had malnutrition risk (NRS ≥ 3: 65.6% vs 11.0%, p < 0.001) and severe neurological impairment (GCS 3-8: 31.2% vs 8.8%, p < 0.001) than controls. Median length of hospital stay was longer in HAIs (40 vs 5.4 days, p < 0.001). Mean NLR was higher in HAIs (9.25 ± 6.11) than controls (7.99 ± 5.21, p = 0.0001), peaking at 12.78 in patients with central nervous system tumors. An NLR ≥ 17.7 predicted in-hospital mortality with 57.1% sensitivity and 89.4% specificity. In controls, mortality increased significantly above this threshold (χ2 = 14.83, p = 0.00012), whereas in HAIs the association was not significant. NLR was not linked to hospital stay.
Conclusion:
NLR is a cost-effective marker predicting in-hospital mortality in neurosurgical patients without HAIs, with ≥ 17.7 identifying high-risk cases. Its prognostic value in HAIs is limited and requires multicenter validation.
