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The neutrophil-lymphocyte count ratio as a diagnostic marker for bacteraemia: A systematic review and meta-analysis

  • Author Footnotes
    1 Jiawei Jiang and Rui Liu contributed equally to this work.
    Jiawei Jiang
    Footnotes
    1 Jiawei Jiang and Rui Liu contributed equally to this work.
    Affiliations
    Department of Critical Care Medicine, Tianjin Medical University First Center Clinical College, Tianjin, People's Republic of China
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  • Author Footnotes
    1 Jiawei Jiang and Rui Liu contributed equally to this work.
    Rui Liu
    Footnotes
    1 Jiawei Jiang and Rui Liu contributed equally to this work.
    Affiliations
    Department of Critical Care Medicine, Tangdu Hospital, Second Affiliated Hospital of Air Force Military Medical University, Xian, People's Republic of China
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  • Xin Yu
    Affiliations
    Department of Critical Care Medicine, Tianjin Medical University First Center Clinical College, Tianjin, People's Republic of China
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  • Rui Yang
    Affiliations
    Department of Critical Care Medicine, Tianjin Medical University First Center Clinical College, Tianjin, People's Republic of China
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  • Hua Xu
    Affiliations
    Department of Critical Care Medicine, Tianjin First Center Hospital, Tianjin, People's Republic of China

    Tianjin First Center Hospital Emergency Medical Research Institute, Tianjin, People's Republic of China
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  • Zhi Mao
    Affiliations
    Department of Critical Care Medicine, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
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  • Yongqiang Wang
    Correspondence
    Corresponding author at: Tianjin First Center Hospital, No. 24 Fukang Roads, Nankai District, Tianjin 300192, People's Republic of China.
    Affiliations
    Department of Critical Care Medicine, Tianjin First Center Hospital, Tianjin, People's Republic of China

    Tianjin First Center Hospital Emergency Medical Research Institute, Tianjin, People's Republic of China
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  • Author Footnotes
    1 Jiawei Jiang and Rui Liu contributed equally to this work.
Published:October 29, 2018DOI:https://doi.org/10.1016/j.ajem.2018.10.057

      Abstract

      Background

      Bacteraemia is a common cause of increased morbidity and mortality in critically ill patients, but its early diagnosis and identification are complicated. The neutrophil-lymphocyte count ratio (NLCR) has been suggested as a useful indicator for the diagnosis of bacteraemia. We performed this meta-analysis to investigate the diagnostic accuracy of the NLCR for bacteraemia.

      Methods

      We searched the PubMed, Embase, Web of Science, and Cochrane Library databases for this meta-analysis. We calculated individual and pooled sensitivities and specificities. I2 statistics and Cochran's Q test were used to evaluate heterogeneity, and the cause of heterogeneity was explored with sensitivity analyses.

      Results

      In total, 8 of 1086 eligible articles were included in the present meta-analysis. The pooled analyses revealed that the diagnostic accuracy of the NLCR in terms of its bacteraemia sensitivity was 0.723 [95% CI: 0.660, 0.777], and its specificity was 0.596 [95% CI: 0.556, 0.634]. The area under the summary receiver operating characteristic curve was 0.69 [95% CI 0.65–0.73].

      Conclusion

      The NLCR is an easy-to-collect marker for bacteraemia. However, the NLCR is inadequate, and only a combination of multiple biomarkers will improve its diagnostic accuracy for bacteraemia.

      Keywords

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