Hubungan Rasio Neutrofil Limfosit dengan Mortalitas ≤28 hari di General Intensive Care Unit RSUP Dr. Mohammad Hoesin Palembang

Muhammad David Riandy, Bernhard Arianto Purba, Yusni Puspita, Rizal Zainal, Legiran Siswo

Abstract


Rasio neutrofil limfosit adalah metode yang cepat dan sederhana untuk mengevaluasi stres peradangan dan memprediksi mortalitas di ruangan intensif. Penelitian ini bertujuan mengetahui hubungan rasio neutrofil-limfosit dengan mortalitas ≤28 hari di ruangan rawat intensif. Penelitian ini menggunakan desain penelitian cross sectional berdasarkan data sekunder rekam medis dengan sampel semua pasien yang dirawat di ICU RSUP Dr. Mohammad Hoesin Palembang dari Januari–Desember 2018. Didapatkan total sampel sebanyak 562 sampel, dan sebanyak 347 yang memenuhi kriteria inklusi. Pada uji analisis regresi diagnosis, kelompok usia, jenis kelamin dan terapi terhadap nilai rasio neutrofil limfosit, didapatkan bahwa diagnosis merupakan faktor risiko yang dapat memengaruhi nilai rasio neutrofil limfosit (p=0,001). Pada distribusi subjek berdasarkan rasio neutrofil limfosit terhadap mortalitas terdapat rerata rasio neutrofil limfosit pada kelompok yang meninggal adalah 17,75±15,06 dan rerata rasio neutrofil limfosit subjek pada kelompok yang hidup adalah 13,63±10,71. Dilakukan Uji Mann-Whitney dan didapatkan bahwa terdapat perbedaan rerata antara rasio neutrofil limfosit antara kelompok yang hidup dan meninggal dengan nilai p=0,009. Simpulan, rasio neutrofil limfosit merupakan salah satu biomarker yang dapat memprediksi mortalitas pada pasien di ICU RSUP Dr. Moh. Hoesin Palembang.

 

Relation between Neutrophil-to-Lympocyte Ratio and ≤28 day Mortality in General Intensive Care Unit of Dr. Mohammad Hoesin General Hospital Palembang

Neutrophil lymphocyte ratio is a fast and simple method for evaluating inflammatory stress and predicting mortality in intensive care. The purpose of this study was to determine the relationship between the ratio of neutrophils to lymphocytes to ≤28 day mortality in the intensive care unit. This was a crosssectional study on secondary data collected from medical records of all patients treated at the ICU of Dr. Mohammad Hoesin General Hospital Palembang during the period of January–December 2018. A total sample of 562 samples was obtained and 347 of them met the inclusion criteria. When diagnosis, age group, gender, and therapy for neutrophil-lymphocyte ratio value were subjected to regression analysis, it was revealed that diagnosis was a risk factor that could affect the neutrophil-lymphocyte ratio value (p=0,001). When subject distribution was assessed based on neutrophil lymphocyte ratio to mortality, an average neutrophil lymphocyte ratio of 17.75±15.06 was observed in the deceased group while the average ratio in survived patients was 13.63±10.71. Mann-Whitney test was then performed and a difference in the neutrophil to lymphocyte ratio was found between the survived and deceased groups with a p value of 0.009. In conclusion, neutrophil to lymphocyte ratio can be used as one of the biomarkers that can predict mortality in patients treated in intensive care unit.


Keywords


Intensive Care Unit (ICU), mortalitas, rasio neutrofil limfosit

Full Text:

PDF

References


Minne L, Abu-Hanna A, Jonge E de. Evaluation of SOFA-based models for predicting mortality in the ICU: a systematic review. Crit Care. 2008;12(6):1–13.

Salciccioli JD, Marshall DC, Pimentel MAF, Santos MD, Pollard T, Celi AA, dkk. The association between the neutrophil-to-lymphocyte ratio and mortality in critical illness: an observational cohort study. Crit Care. 2015;19(1):1–8.

Jilma B, Blann A, Pernerstorfer T, Stohlawetz P, Eichler H, Vondrovec B, dkk. Regulation of adhesion molecules during human endotoxemia no acute effects of aspirin. Am J Respir Crit Care Med. 1999;159(14):857–63.

Darmawan. Peran rasio netrofil limfosit sebagai prediktor major adverse cardiac events tujuh hari dalam perawatan pada pasien sindrom koroner akut. Universitas Indonesia; 2016.

Cho H, Hur HW, Kim SW, Kim SH, Kim JH, Kim YT, dkk. Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother. 2009;58(1):15–23.

Silbernagl S. Blood. Dalam: Silbernagl S, Lang F, penyunting. Color Atlas of Pathophysiology. New York: Thieme; 2000. hlm. 28–65.

Forget P, Khalifa C, Defour JP, Latinne D, Van Pel MC, De Kock M. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes. 2017;10(1):1–4.

Khouri T, Kabeshova A, Annweiler C, Mercat A, Beauchet O, Lerolle N. Amount of care per survivor in young and older patients hospitalized in intensive care unit: a retrospective study. J Gerontol A Biol Sci Med Sci. 2014;(23):1–8.

Karagoz I, Yoldas H. Platelet to lymphocyte and neutrophil to lymphocyte ratios as strong predictors of mortality in intensive care population. Rev Assoc Med Bras. 2019;65(5):633–6.

Mi SG, Soo JC, Jie AK, Justin SK, Tae HK, Sang ML, et al. Effects of gender on white blood cell populations and neutrophil-lymphocyte ratio following gastrectomy in patients with stomach cancer. J Korean Med Sci. 2007;22(SUPPL.):104–8.

Omar MAK, Aram FO, Banafa NS. Causes of mortality among critically ill patients admitted in intensive care unit. Bahrain Med Bull. 2015;37(3):178–80.

Braber A, Van Zanten ARH. Unravelling post-ICU mortality: predictors and causes of death. Eur J Anaesthesiol. 2010;27(5):486–90.

Azab B, Camacho-Rivera M, Taioli E. Average values and racial differences of neutrophil lymphocyte ratio among a nationally representative sample of United States subjects. PLoS One. 2014;9(11):1–6.

McLachlan JM, Chan DL, Crumbaker MA, Marx GM. Neutrophil-lymphocyte ratio prior to steroids as a prognostic marker in men with metastatic castration-resistant prostate cancer. Cancer Treat Commun. 2015;4(August):81–5.

Ghaffari S, Nadiri M, Pourafkari L, Sepehrvand N, Movasagpoor A, Rahmatvand N, dkk. The predictive value of total neutrophil count and neutrophil/lymphocyte ratio in predicting in-hospital mortality and complications after STEMI. J Cardiovasc Thorac Res. 2014;6(1):35–41.

Georges Q, Azoulay E, Mokart D, Soares M, Jeon K, Oeyen S, dkk. Influence of neutropenia on mortality of critically ill cancer patients: results of a meta-analysis on individual data. Crit Care. 2018;22(1):326.

Azab B, Chainani V, Shah N, McGinn JT. Neutrophil-lymphocyte ratio as a predictor of major adverse cardiac events among diabetic population: A 4-year follow-up study. Angiology. 2013;64(6):456–65.

Liu X, Shen Y, Wang H, Ge Q, Fei A, Pan S. Prognostic significance of neutrophil-to-lymphocyte ratio in patients with sepsis: a prospective observational study. Mediators Inflamm. 2016;2016(1):1–8.

Yamanaka T, Matsumoto S, Teramukai S, Ishiwata R, Nagai Y, Fukushima M. The baseline ratio of neutrophils to lymphocytes is associated with patient prognosis in advanced gastric cancer. Oncology. 2008;73(3–4):215–20.

Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008;102(6):653–7.




DOI: https://doi.org/10.15851/jap.v7n3.1829



 

This Journal indexed by

                               


 
Creative Commons License
JAP is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 


View My Stats