Neutrophil to lymphocyte count ratio as an early indicator of blood stream infection in the emergency department
Neutrophil to lymphocyte count ratio as an early indicator of blood stream infection in the emergency department
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DOI：
10.1136/emermed-2014-204071
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发表时间：
2015-07-01
影响因子：
3.1
通讯作者：
Mills, Hannah
中科院分区：
文献类型：
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作者：
Lowsby, Richard;Gomes, Clint;Mills, Hannah
目的早期发现血流感染（BSI），尤其是菌血症，对改善预后具有重要意义。严重感染的初始阶段可能以外周血中中性粒细胞数量增加和淋巴细胞计数（LC）下降为特征。中性粒细胞LC比（NLCR）以前已与传统的测试，如C-反应蛋白（CRP）和白色细胞计数（WCC）进行了比较，并已被提出作为一个有用的标志物，及时诊断bacteraemia.Methods数据连续成人患者在研究期间，2009年11月至2010年10月，到急诊科发热性疾病进行了分析。主要结果指标为血培养阳性（菌血症）。对NLCR、CRP、WCC、中性粒细胞计数和LC的敏感性、特异性、阳性预测值、阴性预测值和似然比进行了测定。血培养阳性270例，菌血症患病率为13.8%。除WCC外，菌血症患者和非菌血症患者的每种标志物的平均值均存在显著差异（p
Objectives Early identification of patients with blood stream infection (BSI), especially bacteraemia, is important as prompt treatment improves outcome. The initial stages of severe infection may be characterised by increased numbers of neutrophils in the peripheral blood and depression of the lymphocyte count (LC). The neutrophil to LC ratio (NLCR) has previously been compared with conventional tests, such as C-reactive protein (CRP) and white cell count (WCC), and has been proposed as a useful marker in the timely diagnosis of bacteraemia.Methods Data on consecutive adult patients presenting to the emergency department with pyrexial illness during the study period, November 2009 to October 2010, were analysed. The main outcome measure was positive blood cultures (bacteraemia). Sensitivity, specificity, positive and negative predictive values and likelihood ratios were determined for NLCR, CRP, WCC, neutrophil count and LC.Results 1954 patients met the inclusion criteria. Blood cultures were positive in 270 patients, hence the prevalence of bacteraemia was 13.8%. With the exception of WCC, there were significant differences in the mean value for each marker between bacteraemic and non-bacteraemic patients (p