Correlation Between Neutrophil-lymphocyte Count Ratio and Procalcitonin in Sepsis and Septic Shock

Jonathan Jonathan, Erwin Pradian, Ardi Zulfariansyah

Abstract


Sepsis is one of the leading causes of death in patients with infection. Procalcitonin is one of the laboratory parameters that is used to differentiate between thesystemic inflammatory responses caused by pathogens and non-pathogens. Neutrophil-lymphocyte count ratio (NLCR) is one of the simple laboratory parameters used. The purpose of this study was to investigate the correlation between NLCR and procalcitonin for sepsis and septic shock patients. A cross-sectional prospective correlational analysis study was perfromed on 36 sepsis and septic shock patients admitted to the Intensive Care Unit of Dr. Hasan Sadikin Bandung General Hospital during September 2017–May 2018. Statistical analysis was performed using Rank Spearman’s and Mann Whitney test. Both procalcitonin and NLCR increased in sepsis and septic shock patients. Procalcitonin level was significantly different in sepsis and septic shock groups (p<0.05), albeit insignificant difference in NLCR (p>0.05). NLCR was significantly higher in gram positive bacteria patient group (p<0,05); however, the difference was not seen for procalcitonin level (p>0.05). Correlation test found a significant positive correlation between SOFA score and procalcitonin (R=0.557 and p<0.01) and no correlation between SOFA score and NLCR (R=0.117 and p>0.05). There was no correlation between NLCR and procalcitonin for sepsis and septic shock patients (R=0.122 and p>0.05). Therefore, no correlation was found between NLCR and procalcitonin for sepsis and septic shock patients.


Korelasi antara Rasio Hitung Neutrofil-Limfosit dan Prokalsitonin pada Pasien Sepsis dan Syok Sepsis

Sepsis merupakan salah satu penyebab kematian terbanyak pada pasien infeksi. Pemeriksaan prokalsitonin merupakan salah satu parameter untuk membedakan bahwa respons inflamasi sistemik disebabkan oleh patogen atau non-patogen. Parameter laboratorium lain yang lebih sederhana adalah rasio hitung neutrofil-limfosit (neutrophil-lymphocyte count ratio/NLCR). Tujuan penelitian ini mengetahui korelasi antara NLCR dan prokalsitonin pada pasien sepsis dan syok sepsis. Penelitian analisis korelasional prospektif ini dilakukan dengan desain potong lintang terhadap 36 pasien sepsis dan syok septik yang dirawat di ICU Rumah Sakit Dr. Hasan Sadikin Bandung periode September 2017–Mei 2018. Analisis statistik menggunakan Uji Rank Spearman dan Mann Whitney. Kadar prokalsitonin dan NLCR meningkat pada pasien sepsis dan syok septik. Kadar prokalsitonin berbeda secara signifikan pada kelompok sepsis dan syok septik (p<0,05), perbedaan tidak terlihat untuk NLCR (p>0,05). NLCR secara signifikan lebih tinggi pada bakteri gram positif daripada bakteri gram negatif (p<0,05), perbedaan tidak terlihat pada kadar prokalsitonin (p>0,05). Uji korelasi menunjukkan korelasi positif yang signifikan antara skor SOFA dan prokalsitonin (R=0,557; p<0,01) dan tidak terdapat korelasi antara skor SOFA dengan NLCR (R=0,117; p>0,05). Tidak terdapat korelasi antara NLCR dan prokalsitonin pada pasien sepsis dan syok septik (R=0,122; p> 0,05). Simpulan: tidak terdapat korelasi antara NLCR dan prokalsitonin pada pasien sepsis dan syok septik.


Keywords


Neutrophil-lymphocyte count ratio, procalcitonin, sepsis, SOFA score

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DOI: https://doi.org/10.15395/mkb.v51n3.1642

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