CLINICAL RESEARCH
Can neutrophil/lymphocyte ratio, C-reactive protein (CRP) and procalcitonin predict the hospitalization time in patients with lower tract respiratory infections?
1
Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training Research Hospital, Istanbul, Turkey
2
Bakirköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
3
Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
Submission date: 2025-03-03
Acceptance date: 2025-03-19
Publication date: 2025-04-10
Corresponding author
Alı Cetınkaya
Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training Research Hospital Istanbul, Turkey
Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training Research Hospital Istanbul, Turkey
Arch Med Sci Civil Dis 2025;10(1):1-10
KEYWORDS
C-reactive proteinlength of staylower respiratory tract infectionsneutrophil/lymphocyte ratioprocalcitonin
TOPICS
ABSTRACT
Introduction:
Lower respiratory tract infections (LTRI) are important hospitalization cause in pulmonary wards. The hospitalization time directly affects hospitalization costs. We aimed to find out whether the blood neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP) and procalcitonin (PCT) values predict the hospitalization time in patients with LTRI.
Material and methods:
We evaluated patients retrospectively between January 2016 and December 2018 in a cross-sectional study. 1297 patients with the diagnosis of pneumonia, chronic obstructive pulmonary disease (COPD) exacerbation, bronchiectasis exacerbation, parapneumonic effusions, and empyema were included in the study according to ICD-10 and hospitalization criteria guidelines.
Results:
Of 1297 patients, 762 (58.75%) were male and median age was 63 (interquartile range (IQR): 55–75). Median hospitalization time was 7 (IQR: 5–10) days. Median NLR was 6.28 (3.78–10.92), median CRP was 79.2 (IQR: 26.7–171.5) mg/l and median PCT was 0.23 (IQR: 0.08–0.51) ng/ml. Over 7 days’ hospitalization time was accepted as long-term hospitalization time. Median NLR was 5.73 (IQR: 5.51–10.16) in < 7 days, 6.94 (IQR: 4.22–11.77) in > 7 days. The difference was statistically significant between the groups (p = 0.000). Median CRP value was 61.5 (IQR: 21.75–139.70) mg/l in ≤ 7 days, and 109.4 (IQR: 22.4–199.5) mg/l in > 7 days. The difference was significant between the groups (p < 0.001). Median PCT value was 0.20 (IQR: 0.07–0.45) mg/l ≤ 7 in days and 0.28 (IQR: 0.10–0.55) mg/l in > 7 days. The difference was not significant between the groups (p = 0.055). For the multivariate analysis, the possible factors identified with univariate analyses were further entered into a logistic regression analysis to determine independent predictors of long-term hospitalization. The odds ratio for CRP was OR = 0.004 (p < 0.001), but NLR and PCT was not significant (p = 0.777, p = 0.784, respectively). Sputum culture positivity and radiological infiltration were associated with the long-term hospitalization (p = 0.003 and p = 0.027, respectively).
Conclusions:
CRP value was associated with the long-term hospitalization in patients with LTRI, but not with NLR and PCT. Sputum culture positivity and radiological infiltration might affect the long-term hospitalization.
Lower respiratory tract infections (LTRI) are important hospitalization cause in pulmonary wards. The hospitalization time directly affects hospitalization costs. We aimed to find out whether the blood neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP) and procalcitonin (PCT) values predict the hospitalization time in patients with LTRI.
Material and methods:
We evaluated patients retrospectively between January 2016 and December 2018 in a cross-sectional study. 1297 patients with the diagnosis of pneumonia, chronic obstructive pulmonary disease (COPD) exacerbation, bronchiectasis exacerbation, parapneumonic effusions, and empyema were included in the study according to ICD-10 and hospitalization criteria guidelines.
Results:
Of 1297 patients, 762 (58.75%) were male and median age was 63 (interquartile range (IQR): 55–75). Median hospitalization time was 7 (IQR: 5–10) days. Median NLR was 6.28 (3.78–10.92), median CRP was 79.2 (IQR: 26.7–171.5) mg/l and median PCT was 0.23 (IQR: 0.08–0.51) ng/ml. Over 7 days’ hospitalization time was accepted as long-term hospitalization time. Median NLR was 5.73 (IQR: 5.51–10.16) in < 7 days, 6.94 (IQR: 4.22–11.77) in > 7 days. The difference was statistically significant between the groups (p = 0.000). Median CRP value was 61.5 (IQR: 21.75–139.70) mg/l in ≤ 7 days, and 109.4 (IQR: 22.4–199.5) mg/l in > 7 days. The difference was significant between the groups (p < 0.001). Median PCT value was 0.20 (IQR: 0.07–0.45) mg/l ≤ 7 in days and 0.28 (IQR: 0.10–0.55) mg/l in > 7 days. The difference was not significant between the groups (p = 0.055). For the multivariate analysis, the possible factors identified with univariate analyses were further entered into a logistic regression analysis to determine independent predictors of long-term hospitalization. The odds ratio for CRP was OR = 0.004 (p < 0.001), but NLR and PCT was not significant (p = 0.777, p = 0.784, respectively). Sputum culture positivity and radiological infiltration were associated with the long-term hospitalization (p = 0.003 and p = 0.027, respectively).
Conclusions:
CRP value was associated with the long-term hospitalization in patients with LTRI, but not with NLR and PCT. Sputum culture positivity and radiological infiltration might affect the long-term hospitalization.
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| ISSN: | 2451-0637 |
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