Neutrophil-lymphocyte ratio and procalcitonin levels in sepsis patients

Background: Mortality in sepsis patients is still quite high. Delayed diagnosis will further increase mortality in septic patients. Microbiological culture examination is a standard diagnosis of sepsis which takes a relatively long time and low sensitivity. Currently procalcitonin is a reliable biomarker for the diagnosis and prognosis of sepsis patients. The neutrophil-lymphocyte ratio is a simple test that has been tested as a diagnostic marker for bacterial infection. We determined the correlation between neutrofil-limfosit rasio and procalcitonin level in sepsis patiens.
Method: This study was an observational analytic with cross-sectional design conducted on sepsis patients aged of 18-60. The neutrophil-lymphocyte ratio was determined using Sysmex XN 1000 hematologyanalyzer. Procalcitonin levels were measured using VIDAS®BRAHMS PCT with the enzyme-linked fluorescence assay principle. The correlation between the ratio of neutrophillymphocytes and procalcitonin levels was statistically analyzed using Spearman correlation test.
Results: There were 30 subjects enrolled in this study. From microbial culture 63.3%-gram negative bacteria were identified. Median ratio of neutrophils-lymphocytes and procalcitonin was 12.05 (6.48-24.27) and 2.85ng/ml (0.75-88.42 ng/ml), respectively. The neutrophil-lymphocyte ratio in gram negative and procalcitonin were 12.07 ± 3.52 and 10.34 ± 22.92 ng/ml, respectively. While that of grams positive was 15.76 ± 4.36, and 6.02 ± 4.26 ng/ml, respectively. The ratio of neutrophils-lymphocytes and procalcitonin in sepsis, severe sepsis, and septic shock were 10.08 ± 3.34 and 1.79 ± 1.39 ng/ml, 12.11 ± 4.08 and 3.56 ± 2, 79 ng/ml, 15,78 ± 6,10, and 23,19 ± 31,33 ng/ml, respectively. Spearman’s correlation test showed a strong and significant correlation (rs = 0.68, p <0.01).; p<0.01).between the ratio of neutrophil-limphocytes and procalcitonin levels in sepsis patients Conclusion: There was a strong and significant correlation between the ratio of neutrophillimphocytes and procalcitonin levels in sepsis patients.