Relation of NLR Value and Mortality Rate in Neonatal Sepsis

Jarwoto Roestanajie, Muhammad Ali Shodikin

Abstract

Introduction: Neonatal sepsis is a significant issue for newborns everywhere and causes a large amount of morbidity and mortality. Various indicators of newborn sepsis are expensive and occasionally unavailable in peripheral hospitals. The neutrophil-lymphocyte ratio (NLR), which is affordable, is a component of complete blood counts and does not call for further testing. This study intended to investigate the neutrophil-to-lymphocyte ratio (NLR) as a predictor of neonatal mortality rate in the local hospital in rural locations.

Methods: This study sampled newborns with sepsis in the perinatal room of dr. Soebandi Hospital Jember for this cross-sectional study, from January 2021 to June 2022. NLR is calculated by manually dividing the number of neutrophils by the actual number of lymphocytes. Our neutrophil and lymphocyte data were obtained from the patient's lab results. This study analyzed neonatal sepsis NLR data using Spearman analysis to find the relation between NLR value and mortality rate of neonatal sepsis.

Results: This study obtained 43 data on neonatal sepsis in the perinatology ward during this period. The data found to show that 37 neonatal sepsis survived and 6 died. The collected data analysis found that the lowest NLR neonatal sepsis is 0.4, the highest NLR neonatal sepsis is 25.6 and the mean value for NLR neonatal sepsis in perinatology was 3.88. This study found no correlation between the NLR value of the sepsis neonate and the neonatal mortality rate Sig. (2-tailed) 0.662.

Conclusion: In this study demonstrated no correlation between the NLR value of the sepsis neonates and the neonatal mortality rate.

Keywords

lymphocytes; mortality; neonatal sepsis; neutrophils

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References

1. Alkan Ozdemir, S., Arun Ozer, E., Ilhan, O. & Sutcuoglu, S. Can neutrophil to lymphocyte ratio predict late-onset sepsis in preterm infants? J. Clin. Lab. Anal. 32, 4–8 (2018).

2. Hasibuan, B. S. Comparison of microbial pattern in early and late onset neonatal sepsis in referral center Haji Adam Malik hospital Medan Indonesia. IOP Conf. Ser. Earth Environ. Sci. 125, (2018).

3. Polin, R. A. et al. Management of Neonates with Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics 129, 1006–1015 (2012).

4. Wilar, R. & Lestari, H. Risk Factors and Clinical Outcomes of Neonatal Sepsis in Manado Tertiary Referral Hospital: A Single-center Study. Open Access Maced. J. Med. Sci. 10, 93–98 (2022).

5. Haque, K. N. Definitions of bloodstream infection in the newborn. Pediatr. Crit. Care Med. 6, 45–49 (2005).

6. Kardana, I. M. Incidence and factors associated with mortality of neonatal sepsis. Paediatr. Indones. 51, 144 (2011).

7. Holub, M., Beran, O., Kaspříková, N. & Chalupa, P. Neutrophil to lymphocyte count ratio as a biomarker of bacterial infections. Cent. Eur. J. Med. 7, 258–261 (2012).

8. Hamiel, U. et al. Diagnostic markers of acute infections in infants aged 1 week to 3 months: A retrospective cohort study. BMJ Open 8, 1–10 (2018).

9. Sumitro, K. R., Utomo, M. T. & Widodo, A. D. W. Neutrophil-to-lymphocyte ratio as an alternative marker of neonatal sepsis in developing countries. Oman Med. J. 36, 514–519 (2021).

10. Dessu, S., Habte, A., Melis, T. & Gebremedhin, M. Survival Status and Predictors of Mortality among Newborns Admitted with Neonatal Sepsis at Public Hospitals in Ethiopia. Int. J. Pediatr. (United Kingdom) 2020, (2020).

11. Adonis Muganza, N. et al. Predictors of mortality in neonatal sepsis in a resource-limited setting. J. Adv. Pediatr. Child Heal. 4, 057–061 (2021).

12. Xin, Y. et al. Accuracy of the neutrophil-to-lymphocyte ratio for the diagnosis of neonatal sepsis: A systematic review and meta-analysis. BMJ Open 12, 1–7 (2022).

13. Iroh Tam, P. Y. & Bendel, C. M. Diagnostics for neonatal sepsis: Current approaches and future directions. Pediatr. Res. 82, 574–583 (2017).

14. Shane, A. L., Sánchez, P. J. & Stoll, B. J. Neonatal sepsis. Lancet 390, 1770–1780 (2017).

15. Kovach, M. A. & Standiford, T. J. The function of neutrophils in sepsis. Curr. Opin. Infect. Dis. 25, 321–327 (2012).

16. Li, R. H. L. & Tablin, F. A comparative review of neutrophil extracellular traps in sepsis. Front. Vet. Sci. 5, 1–11 (2018).

17. Czaikoski, P. G. et al. Neutrophil extracellular traps induce organ damage during experimental and clinical sepsis. PLoS One 11, (2016).

18. Stearns-Kurosawa, D. J., Osuchowski, M. F., Valentine, C., Kurosawa, S. & Remick, D. G. The pathogenesis of sepsis. Annu. Rev. Pathol. Mech. Dis. 6, 19–48 (2011).

19. Gacouin, A., Tribut, O., Amiot, L. & Tattevin, P. SHOCK IS ASSOCIATED WITH POOR OUTCOME Yves Le Tulzo , Ce. 18, 487–494 (2002).

20. Tomar, B., Anders, H. J., Desai, J. & Mulay, S. R. Neutrophils and Neutrophil Extracellular Traps Drive Necroinflammation in COVID-19. Cells 9, 1–8 (2020).

21. Pai, H. S. Neutrophil to lymphocyte ratio as a marker of neonatal sepsis in resource limited settings. Int. J. Contemp. Pediatr. 9, 1047 (2022).

22. Ni, J., Wang, H., Li, Y., Shu, Y. & Liu, Y. Neutrophil to lymphocyte ratio (NLR) as a prognostic marker for in-hospital mortality of patients with sepsis: A secondary analysis based on a single-center, retrospective, cohort study. Medicine (Baltimore). 98, e18029 (2019).

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