Abstract
Background
Neutrophil-to-lymphocyte ratio (NLR) has been used to predict the prognosis of patients
with sepsis with inconsistent results. This meta-analysis aimed to clarify the prognostic
value of NLR in patients with sepsis.
Methods
A comprehensive literature search for relevant studies, published prior to March 2019,
was conducted using PubMed, Web of Science, and the China National Knowledge.
Infrastructure database. Standard mean differences (SMDs) with 95% confidence intervals
(CI) were used to evaluate the NLR of patients with sepsis retrospectively. Hazard
ratios (HRs) with 95% CIs were used to evaluate the prognostic value of NLR in patients
with sepsis.
Results
Patients from 14 studies (n = 11,564) were selected for evaluation. Nine studies (1371
patients) analyzed the NLR in these patients. The pooled results showed significantly
higher NLR in non-survivors than in survivors (random-effects model: SMD = 1.18, 95%
CI; 0.42–1.94). Nine studies (10,685 patients) evaluated the prognostic value of NLR
for sepsis; the pooled results showed that higher NLR was associated with poor prognosis
in patients with sepsis (fixed-effects model: HR = 1.75, 95% CI; 1.56–1.97). Subgroup
analysis revealed that study design, cut-off NLR, or primary outcome did not affect
the prognostic value of NLR in patients with sepsis.
Conclusion
This meta-analysis indicates that NLR may be a helpful prognostic biomarker of patients
with sepsis and that higher NLR values may indicate unfavorable prognoses in these
patients.
Keywords
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Article Info
Publication History
Published online: November 18, 2019
Accepted:
October 16,
2019
Received in revised form:
October 8,
2019
Received:
May 13,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
