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Neutrophil-to-lymphocyte ratio in patients with gram-negative sepsis admitted to intensive care unit.

INTRODUCTION
Several studies have investigated the role of Neutrophil to Lymphocyte Ratio (N/L ratio) in the early diagnosis of infection, which had different results. We assessed this ratio in early diagnosis of Gram-negative sepsis admitted to ICU.


METHODS
This cross sectional study was approved by ethics committee of Urmia University of Medical Sciences and conducted during 2015. All patients with gram negative sepsis admitted to general intensive care unit (GICU) were enrolled. Demographic characteristics, APACHE II score, duration of mechanical ventilation and ICU length of stay, average neutrophil, lymphocyte count, and their ratio on the first, second and third day of hospitalization, and mortality were recorded. P < 0.05 was significant.


RESULTS
One hundred and thirty nine patients were studied during one year with mean age 68.29 ±17. 4 years. 136 patients received mechanical ventilation with mean 13.85 ±2.07 days. The mean white blood cells count on the first day of hospitalization was 11776.04±5789.60,and on the second and third days was 12446±2101.16 and 13241.01 ± 7077.17, respectively. The ratio of neutrophil to lymphocyte on the day of hospitalization was 11.38±1.02. This ratio on the second and third days was 11.98±0.99 and 12.94±1.3, respectively. Furthermore, 46.8% of patients died. According to the T-test, significant difference was seen between two groups in term of APACHEII score, count of neutrophil, WBC and N/L ratio on the second and third days (p < 0.05).


CONCLUSION
Blood cell analysis and N/L ratio can be used as a predictor for severity of gram negative sepsis along with other diagnostic procedures.