The following is a summary of “Blood neutrophil to lymphocyte ratio is associated with 90-day mortality and 60-day readmission in Gram negative bacteremia: a multi-center cohort study,” published in the February 2024 issue of Infectious Diseases by Roldgaard et al.

Researchers conducted a retrospective study to explore the potential of the Neutrophil-Lymphocyte Ratio (NLR) as a predictor for mortality and readmission in Gram-negative bacteremia (GNB) patients, building on its established role in predicting bacteremia in emergency departments and mortality in sepsis ICU cases.

They conducted a retrospective cohort study involving GNB patients treated at six hospitals in the Capital Region of Denmark (from 2018 to 2022). Exclusion criteria comprised immunosuppressed individuals and those lacking NLR values upon blood culture. They utilized logistic regression models to investigate the correlation between NLR levels and 90-day all-cause mortality. Employing the logit link interpretation of the cumulative incidence function, they evaluated the link between NLR levels and 60-day readmission. Associations were expressed as OR with corresponding 95% CI.

The results showed that of 1,763 patients, the median age was 76.8 years, with 51.3% female. The median NLR stood at 17.3, with 15.8% of patients exhibiting a quick sequential organ failure assessment score of two or three. Urinary tract infection (UTI) emerged as the predominant focus, with Escherichia coli being the most common pathogen. Significant disparities in median NLR were observed across age groups and pathogens, as well as among patients with/without hypertension, liver disease, chronic obstructive pulmonary disease, dementia, and alcohol abuse. A total of 378 patients (21.4%) succumbed within 90 days, while 526 (29.8%) were readmitted to the hospital within 60 days. With each doubling of the NLR, the odds ratio for all-cause 90-day mortality was 1.15 (95% CI, 1.04–1.27), and for 60-day readmission, it was 1.12 (95% CI, 1.02–1.24). Subgroup analyses did not reveal statistically significant differences in the association between NLR and mortality. The discriminatory ability of NLR for predicting mortality was modest, comparable to blood neutrophil or lymphocyte count, yielding receiver operating characteristic curves with an area under the curve of 0.59 (95% CI, 0.56–0.63), 0.60 (95% CI, 0.56–0.65), and 0.53 (95% CI, 0.49–0.56).

Investigators concluded that while the blood NLR ratio is linked to 90-day mortality and 60-day readmission in GNB patients, its ability to predict these outcomes is limited.

Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09127-0