Neutrophil Count Percentage and Neutrophil–Lymphocyte Ratio as Prognostic Markers in Patients Hospitalized for Community-Acquired Pneumonia

• Published in: Archivos de bronconeumología (English ed.) 2019-09, Vol.55 (9), p.472-477
• Main Authors: Curbelo, Jose, Rajas, Olga, Arnalich, Belén, Galván-Román, José María, Luquero-Bueno, Sergio, Ortega-Gómez, Mara, Lancho, Angel, Roy, Emilia, Sánchez Azofra, Ana, Mateo Jiménez, Gloria, Gómez, Manuel, Moldenhauer, Fernando, Aspa, Javier
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biomarcadores; Biomarkers; Cociente neutrófilos/linfocitos; Community-Acquired Infections - blood; Community-Acquired Infections - diagnosis; Community-acquired pneumonia; Female; Hospitalization; Humans; Leukocyte Count; Lymphocytes; Male; Middle Aged; Neumonía adquirida en la comunidad; Neutrophil count percentage; Neutrophils; Neutrophil–lymphocyte ratio; Porcentaje de neutrófilos; Prognosis; Retrospective Studies
• ISSN: 1579-2129; 1579-2129
• DOI: 10.1016/j.arbr.2019.07.002

Community-acquired pneumonia (CAP) is a common serious infection. This study aimed to evaluate the prognostic utility of neutrophil count percentage (NCP) and neutrophil–lymphocyte ratio (NLR) in patients with CAP. Retrospective study of hospitalized patients with CAP. Patients had a blood test at admission and 3–5 days after hospitalization (early-stage test). The main outcome variables were 30-day and 90-day mortality. Two hundred and nine patients were included. Patients who survived had significant reductions in both NCP and NLR between admission and the day 3–5 blood tests (from 85.8% to 65.4% for NCP and from 10.1 to 3.2 for NLR). Twenty-five patients died in the first 90 days. Patients who died had lower, non-significant reductions in NCP (from 84.8% to 74%) and NLR (from 9.9 to 6.9) and significantly higher early-stage NCP and NLR than those who survived. NCP values higher than 85% and NLR values higher than 10 in the early-stage blood test were associated with a higher risk of mortality, even after multivariate adjustment (HR for NCP: 12; HR for NLR: 6.5). NCP and NLR are simple, low-cost parameters with prognostic utility, especially when measured 3–5 days after CAP diagnosis. High NLR and/or NCP levels are associated with a greater risk of mortality at 90 days. La neumonía adquirida en la comunidad (NAC) es una infección frecuente y grave. El objetivo de este trabajo es estudiar la utilidad pronóstica del porcentaje de neutrófilos (NCP) y del cociente neutrófilos/linfocitos (NLR) en pacientes con NAC. Estudio retrospectivo de pacientes hospitalizados por NAC con analítica al ingreso y una segunda extracción de control a los 3-5 días. Se consideraron variables desenlace la mortalidad a 30 y 90 días. Se incluyó a 209 pacientes. Los pacientes que sobrevivieron redujeron significativamente el NCP y el NLR entre la analítica al diagnóstico y la de control (desde el 85,8 hasta el 65,4% para NCP y de 10,1 a 3,2 para NLR). Fallecieron 25 pacientes en los primeros 90 días. En ellos hubo un menor descenso no significativo para el NCP (del 84,8 al 74,0%) y para NLR (de 9,9 a 6,9). Los valores de NCP y NLR en la analítica de control fueron significativamente mayores en los pacientes fallecidos que en los supervivientes. Aquellos pacientes que presentaron en la analítica de control un NCP superior al 85% o un NLR superior a 10, presentaron un riesgo de mortalidad superior tras ajuste multivariable (HR para NCP 12 y para NLR 6,5). NCP y NLR son parámetros sen