Correlation of Neutrophil to Lymphocyte and Monocyte to Lymphocyte Ratio with Acute Phase Reactant in Septicemia: A Prospective Study. NLR and MLR as Alternative in Sepsis

Abstract

Introduction: Acute phase reactants (Procalcitonin, C-Reactive Protein) are important parameters in diagnosing and prognosticating sepsis. Despite availability of these, all the laboratories and hospitals are not equipped with the high end diagnostic capabilities in developing nations. Using alternative available markers in such conditions is preferable. We correlated the ratios from complete blood count with parameters procalcitonin and CRP.Material and Methods: This was a prospective study conducted in tertiary care hospital. All the patients admitted with diagnosis of sepsis who fulfilled the inclusion and exclusion criteria were included in this study. Venous sample were collected from all the patients. Complete blood count, procalcitonin and C reactive protein was done. Ratio of neutrophil to lymphocyte and monocyte to lymphocyte was calculated and correlated.Results: A total of 102 patients were included in this study. 49 were males and 53 females with an average age of 48.72 ± 11.21. The mean NLR was 14.09 ± 3.31 while mean MLR was 0.71 ± 0.15. Average procalcitonin was 25.38 ± 9.34 and the mean CRP was 142.97 ± 32.20. the correlation was checked using pearson’s coefficient. There was a strong correlation between NLR with procalcitonin and CRP which was statistically significant (<0.001). MLR had a strong to moderate correlation with both the parameters and was statistically significant.Conclusion: Calculating the ratio of blood parameters from the complete blood count is the easy and cheap way to diagnose the sepsis in hospitals where high end clinical investigations are not available.