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Neutrophil-to-lymphocyte ratio as a feasible prognostic marker for pyogenic liver abscess in the emergency department

  • Kwang Soon Park
  • Sun Hwa Lee
  • Seong Jong YunEmail author
  • Seokyong Ryu
  • Keon Kim
Original Article
  • 293 Downloads

Abstract

Purpose

The neutrophil-to-lymphocyte ratio (NLR) is an effective predictor of mortality in patients with for various conditions. To date, there are no previous studies on NLR as a prognostic marker for pyogenic liver abscess (PLA), especially on admission to the emergency department (ED).

Methods

From January 2013 to December 2015, 102 patients diagnosed with PLA in the ED were included. Clinico-radiological and laboratory results, including NLR, were evaluated as variables. NLR was calculated as absolute neutrophil count/absolute lymphocyte count. To evaluate the prognosis of PLA, data on hospital mortality, intensive care unit (ICU) admission, and development of septic shock were obtained. Multivariate logistic regression analyses and receiver-operating characteristic (ROC) curve analysis were performed.

Results

Among 102 patients, 10 (9.8%) died, 14 (13.7%) were admitted to the ICU, and 15 (14.7%) developed septic shock during hospitalization. Multivariate logistic regression analysis revealed NLR as an independent factor in predicting death [odds ratio (OR), 1.4; p = 0.020], ICU admission (OR, 1.4; p = 0.021), and development of septic shock (OR, 1.6; p = 0.041). NLR showed an excellent predictive performance for death (areas under the ROC curves [AUC], 0.941; cut-off value, 19.7; p < 0.001), ICU admission (AUC, 0.946; cut-off value, 16.9; p < 0.001), and development of septic shock (AUC, 0.927; cut-off value, 16.9; p < 0.001).

Conclusion

NLR was positively associated with poor prognosis of PLA; elevated NLR could predictor of high risk of death, ICU admission, and development of septic shock. Emergency physicians should consider NLR for the prognosis of PLA and early aggressive treatment, especially in patients with NLR > 16.9.

Keywords

Neutrophil-to-lymphocyte ratio Pyogenic liver abscess Mortality Outcome Prognostic marker 

Notes

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Compliance with ethical standards

Ethical approval

This study has been approved by the ethics committee and has been performed in accordance with the ethical standards laid down in the Declaration of Helsinki.

Informed consent

Due to the retrospective nature of the study, no informed consent was obtained from the included cohort as judged by the ethics committee..

Conflict of interest

The authors declare that there is no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Emergency Medicine, Sanggye Paik HospitalInje University College of MedicineSeoulRepublic of Korea
  2. 2.Department of Radiology, Kyung Hee University Hospital at Gangdong, College of MedicineKyung Hee UniversitySeoulRepublic of Korea
  3. 3.Department of Emergency MedicineEwha Womans University HospitalSeoulRepublic of Korea

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