Neutrophil-lymphocyte ratio in the early diagnosis of sepsis in an intensive care unit: a case-control study

OBJECTIVE: To evaluate the neutrophil-lymphocyte ratio as a predictor of sepsis and mortality in patients admitted to an intensive care unit. METHODS: Case-control study of adult patients admitted to an intensive care unit. Patients who had sepsis as the reason for admission and who had a previous complete blood count examination were included as case patients. The following statistical analyses were performed: ROC curves, binary logistic regression, and Mann-Whitney and Pearson's chi-square tests. p < 0.05 was considered significant. RESULTS: The ROC curve values were 0.62 for neutrophil-lymphocyte ratio, 0.98 for band neutrophils and 0.51 for total leukocytes. The presence of a neutrophil-lymphocyte ratio greater than 5.0, leukocyte count above 12,000mm(3)/mL and band neutrophil percentage above 10% were risk factors for sepsis; however, only the SAPS 3 and SOFA score were related to patient mortality. CONCLUSION: The neutrophil-lymphocyte ratio and band neutrophils in combination with other parameters may be markers for the early detection of sepsis in intensive care units.