Abstract:

Objective

To investigate the predictive value of neutrophil-to-lymphocyte ratio（NLR） in the progression of severe community-acquired pneumonia （SCAP） to sepsis in elderly patients.

Methods

A total of 78 elderly patients with SCAP admitted to Xunyi County Hospital in Xianyang City from January 2022 to October 2023 were selected as the study objects. According to whether they progressed to sepsis， the subjects were divided into sepsis group （n=24） and non-sepsis group （n=54）.T test or χ² test were used for univariate analysis of the relevant data of the two groups. Multivariate Logistic regression was used to analyze the factors influencing the progression of SCAP to sepsis in elderly patients， and receiver operating characteristics （ROC） curve was used to evaluate the predictive value of NLR.

Results

The results of univariate analysis showed that the acute physiology and chroni health evaluation （APACHE） Ⅱ score， procalcitonin （PCT）， NLR， neutrophil count and lymphocyte count were higher in the sepsis group than those in the non-sepsis group （P ＜ 0.05）. Multivariate Logistic regression analysis showed that APACHE-Ⅱ score （OR=1.476， 95%CI: 1.051-2.071）， PCT （OR=1.975，95%CI: 1.295-3.012）， NLR （OR=1.958， 95%CI: 1.259-3.045） were risk factors for the progression of SCAP to sepsis in the elderly （P ＜ 0.05）. ROC curve analysis showed that the area under the curve of NLR for predicting SCAP progression to sepsis in the elderly was 0.858 （95%CI: 0.778-0.939）， which was higher than those of APACHE-Ⅱ score and PCT.

Conclusion

The NLR can effectively predict the risk of SCAP progression to sepsis in the elderly， and the detection is rapid and simple， which is worthy of clinical promotion.

Key words: Severe community-acquired pneumonia, Sepsis, Aged, Neutrophil-to-lymphocyte ratio, Risk prediction