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KMID : 0385920200310060562
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Journal of the Korean Society of Emergency Medicine
2020 Volume.31 No. 6 p.562 ~ p.569
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The role of the neutrophil-to-lymphocyte ratio for the prediction severity in women with acute pyelonephritis in the emergency department
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Song Back-Ho
Park Sang-Hyun
So Byung-Hak
Kim Soo-Hyun
Zhu Jong-Ho
Choi Seung-Pill
Oh Jae-Hun
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Abstract
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Objective: It is difficult to predict medical outcomes for acute pyelonephritis (APN) in women. A delay in diagnosis and treatment results in rapid progression to circulatory collapse, multiple organ failure, and death. We investigated the value of procalcitonin (PCT) and neutrophil-to-lymphocyte ratio (NLR) in APN patients hospitalized through the emergency room.
Method: We retrospectively evaluated women with APN presenting in the emergency room from January 2014 to May 2018. Inflammatory biomarkers, including PCT and NLR, were measured, and the severity of pyelonephritis was assessed using the Surviving Sepsis Campaign definitions (Sepsis-3). Multivariable logistic regression analysis was used to evaluate the risk factors associated with septic shock and the prediction for septic shock was compared using a receiver operating characteristic (ROC) curve.
Results: A total of 357 female patients with APN were included. The median level of PCT and NLR was higher in the septic shock group compared with other groups. Multivariate logistic regression analysis showed that age and PCT were risk factors for septic shock. When the ROC curve of septic shock was compared, PCT showed a higher area under the curve than NLR (NLR 0.65 vs. PCT 0.80).
Conclusion: The initial NLR in the emergency room showed significant differences depending on the severity as classified by Sepsis-3 definitions. However, NLR was not found to be associated with septic shock in female patients with APN.
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KEYWORD
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Neutrophil count, Lymphocyte count, Acute pyelonephritis, Neutrophil to lymphocyte ratio
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