Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Percentage Ratio as Predictors of In-hospital Mortality in Sepsis. An Observational Cohort Study.

Background: Sepsis remains a major public health problem with increased incidence of mortality. As early recognition and prompt treatment in the first 'golden hour' remain the cornerstone of the septic patient approach, there is a real need for rapid and cost-effective reliable markers.

Objective: The aim of the study was to evaluate the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte percentage ratio (PL%R) in patients with sepsis who were initially treated in the Emergency Department and investigate their predictive ability regarding in-hospital mortality and performance comparing them to SOFA, APACHE II, and SAPS II score.

Methods: A retrospective observational study in the Emergency Department and Internal Medicine Department in a Mediterranean University Hospital. A total of forty-three patients suffering from sepsis were enrolled in the study. Demographic information, past medical history with pre-existing co-morbidities, physical examination findings, and radiological data were reviewed. Neutrophil to lymphocyte ratio and platelets to lymphocyte percentage ratio was calculated from the complete blood count (CBC). Disease severity was evaluated by calculating SOFA, SAPS II and APACHE II score on admission. The outcome of patients was noted as a primary endpoint.

Results: Values of NLR and PL%R were statistically significantly higher in the group of non-survivors and correlate with sepsis prognostic scores.

Conclusion: Calculation of NLR and PL%R is easy, fast, and inexpensive in the assessment of patients with sepsis. Their role as prognostic indexes and their validity in the Emergency Department setting should be evaluated with large prospective studies.