Roles of NLR and percentage of neutrophils in assessing the prognosis of sepsis: a single-center retrospective study

Abstract Background: This study aimed to investigate the early predictive value of inflammation-related parameters in-hospital mortality of patients with sepsis. Methods: We retrospectively recruited 606 patients diagnosed with sepsis from January 2009 to October 2022 in Wuhan Union Hospital. The inflammation-related parameters including neutrophil-to-lymphocyte ratio (NLR), neutrophil percentage (NE%), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) in in-hospital survivals and non-survivals on the first, second, third, and seventh days after hospital admission were collected and analyzed. Results: NLR and NE% in non-survivals (n = 185) were significantly higher than those in survivals (n = 421) (p < 0.001). The area under the receiver operating characteristic (ROC) curve (AUC) of NLR or NE% was 0.880 or 0.852 on day 1, 0.770 or 0.790 on day 2, 0.784 or 0.777 on day 3, and 0.732 or 0.741 on day 7. The optimal cut-off value of NLR or NE% for predicting in-hospital mortality were 10.769 or 87.70% on day 1, 17.544 or 90.69% on day 2, 14.395 or 85.00% on day 3, and 9.105 or 83.93% on day 7. The day 1, 2, 3 and 7 NLR, and day 1, 2 and 3 NE% were significant predictors of in-hospital mortality in the Cox proportional hazards models. Conclusions: NLR and NE% were significant early biomarkers for predicting in-hospital mortality of septic patients. The combined NLR and NE% improved the evaluation for further early prediction of in-hospital mortality. Trial registration: ClinicalTrials.gov NCT05636202. Registered 08 November 2022.