The prognostic value of neutrophil-to-lymphocyte ratio combined with multiple indicators in patients with severe pneumonia

This study aims to evaluate the prognostic significance of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), creatinine, and lactic acid in patients diagnosed with severe pneumonia (SP). We conducted a retrospective analysis of patient data from our hospital who were diagnosed with severe pneumonia between June 2020 and June 2023. The patients were divided into two groups: survivors (363 cases) and non-survivors (346 cases). We collected demographic, clinical and laboratory data and used multifactorial logistic regression to identify prognostic risk factors. We also evaluated the predictive accuracy of each parameter using Receiver Operating Characteristic (ROC) curve analysis. Statistical analysis was performed using SPSS 26.0. In the study, it was found that patients who died had higher levels of certain markers in their blood, including NLR, PLR, procalcitonin (PCT), C-reactionprotein (CRP), Brain natriuretic peptide (BNP), blood creatinine, lactic acid and age Shock Index (SI) (p < 0.001). They also had lower levels of partial pressure of oxygen (PO2) and partial pressure carbon dioxide (PCO2) (p < 0.05). On the other hand, patients who survived had lower levels of these markers and higher levels of PO2 and PCO2. After analyzing the data, it was determined that NLR, PLR, creatinine and lactic acid were significant risk factors for poor prognosis in patients with SP. The Area Under ROC Curve (AUCs) for these factors ranged from 0.577 to 0.725, and they had sensitivities ranging from 67.9% to 77.7% and specificities ranging from 61.2% to 80.7%. When these factors were combined, they provided a more accurate evaluation of prognosis, with an AUC of 0.789 and a sensitivity of 67.1% and specificity of 77.4% at the optimal threshold. NLR, PLR, creatinine and lactic acid are significant prognostic indicators in SP patients. A combined assessment of these parameters enhances prognostic accuracy, aiding in better management.

Severe pneumonia; Neutrophil-to-lymphocyte ratio; Platelet-to-lymphocyte ratio; Prognostic value

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