The Journal of Practical Medicine >

2023 , Vol. 39 >Issue 22: 2958 - 2963

DOI: https://doi.org/10.3969/j.issn.1006-5725.2023.22.017

Clinical Research

Predictive value of neutrophil to lymphocyte and platelet ratio in prognosis of children with sepsis

  • Chenyang CHANG ,
  • Shaowen HU ,
  • Guoping DENG ,
  • Huifang ZHU ,
  • Kaiyuan. LUO
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  • *.Department of Pediatrics，the First Affiliated Hospital of Gannan Medical University，Ganzhou 341400，China

Received date: 2023-06-25

  Online published: 2023-12-11

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Abstract

Objective To investigate the predictive value of neutrophil to lymphocyte and platelet ratio （N/LPR） in the prognosis of children with sepsis. Methods Clinical data of 171 children with sepsis admitted to the pediatric intensive care unit （PICU） of the First Affiliated Hospital of Gannan Medical University from January 1st， 2018 to November 30th， 2022 were retrospectively collected. The pediatric clinical illness score （PCIS） within 24 hours after admission was recorded. Procalcitonin （PCT）， C-reactive protein （CRP） and platelet （PLT） count were collected within 24 hours after diagnosis of sepsis. N/LPR， platelet to lymphocyte ratio （PLR）， neutrophil to lymphocyte ratio （NLR）， and neutrophil to prealbumin ratio （NPRI） were calculated. According to the prognosis， the children were divided into survival group （n = 110） and death group （n = 61）. The difference of N/LPR， PLR， NLR， NPRI， PCIS， PCT， CRP and PLT was compared between the two groups. Receiver operating characteristic （ROC） curve was plotted to analyze the accuracy of N/LPR， PLR and PCIS in predicting 28-day mortality risk in children with sepsis. According to the cut-off value of ROC curve， the 28-day mortality risk of children was analyzed in the subgroups， and the Kaplan-Meier method was used to analyze the survival of children with sepsis in each subgroup. According to PCIS， children with sepsis were divided into three groups （non-critical group， critical group and extremely critical group）， and the relationship between N/LPR， PLR and disease severity was evaluated. Results The level of PCT， CRP and N/LPR in the death group were higher than that in the survival group， while the level of PLT， PLR and PCIS was lower than that in the survival group， and the difference was statistically significant （P < 0.05）. ROC curve showed that the area under curve （AUC） of N/LPR， PLR and PCIS for predicting the 28-day mortality risk of children with sepsis was 0.659， 0.595 and 0.716， respectively. Subgroup analysis showed that the risk of death in N/LPR ≥ 1.5 group was higher than that in N/LPR < 1.5 group （χ2 = 11.224， P = 0.001）； that in PLR < 85.58 group was higher than that in PLR ≥ 85.58 group （χ2 = 5.708， P = 0.017）； and that in PCIS ≥ 84 group was lower than that in PCIS < 84 group （χ2 = 19.312， P = 0.000）. The result of survival analysis was consistent with that of subgroup analysis. In addition， N/LPR might be associated with the risk stratification in children with sepsis. Conclusion N/LPR has a certain predictive value for 28-day mortality risk in children with sepsis.

Key words： sepsis; neutrophil to lymphocyte and platelet ratio; prognosis; children

Cite this article

Chenyang CHANG , Shaowen HU , Guoping DENG , Huifang ZHU , Kaiyuan. LUO . Predictive value of neutrophil to lymphocyte and platelet ratio in prognosis of children with sepsis[J]. The Journal of Practical Medicine, 2023 , 39(22) : 2958 -2963 . DOI: 10.3969/j.issn.1006-5725.2023.22.017

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