Can Neutrophil-to-Lymphocyte Ratio Predict Mortality in CAP?

HealthDay News — Neutrophil-to-lymphocyte ratio (NLR) can predict 30-day mortality for elderly adults with community-acquired pneumonia (CAP), according to a study published in the Journal of the American Geriatrics Society.

Emanuela Cataudella, MD, from the University of Catania in Italy, and colleagues conducted a prospective study involving 195 elderly adults admitted for CAP. The researchers compared the accuracy and predictive value for 30-day mortality of traditional scores and NLR.

The researchers found that NLR predicted 30-day mortality (<.001), with better performance for predicting prognosis than the Pneumonia Severity Index (<.05); Confusion, Urea, Respiratory rate, Blood pressure, aged 65 and older (CURB-65); C-reactive protein; and white blood cell count (<.001). 

There were no deaths in participants with a NLR below 11.12. Thirty-day mortality was 30% and 50%, respectively, for those with a NLR between 11.12 and 13.4, and for those with a NLR between 13.4 and 28.3. Within 30 days, all participants with a NLR above 28.3 died.

“In conclusion, NLR showed emerging prognostic value in predicting 30-day mortality,” the researchers write. “The NLR may provide clinicians with quick stratification of patients into different prognostic categories.”

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Cataudella E, Giraffa CM, Di Marca S, et al. Neutrophil-to-lymphocyte ratio: an emerging marker predicting prognosis in elderly adults with community-acquired pneumonia [published online April 13, 2017]. J Am Geriatr Soc. doi: 10.1111/jgs.14894