Title:Utility of the Neutrophil to Lymphocyte Ratio for Predicting Mortality in
Pleural Empyema - A Retrospective Study
Volume: 21
Issue: 3
Author(s): Evgeni Dimitrov*, Daniel Valchev, Georgi Minkov, Emil Enchev and Yovcho Yovtchev
Affiliation:
- Clinic of Surgical Diseases, University Hospital “Prof. Dr. Stoyan Kirkovich” Stara Zagora, Bulgaria
- Department of Surgical
Diseases and Anesthesiology, Faculty of Medicine, Trakia University Stara Zagora, Bulgaria
Keywords:
Empyema, pleural infection, neutrophil to lymphocyte ratio, hematological biomarker, mortality, inflammation.
Abstract:
Purpose: The prognostic qualities of the hematological biomarker neutrophil to lymphocyte
ratio (NLR) have not yet been evaluated in pleural empyema. Therefore, we aimed to
find if NLR can predict adverse outcome in such clinical setting.
Methods: Retrospectively we studied 84 patients with pleural empyema who were operated in
emergency setting in a clinic of thoracic surgery of an academic hospital over a 34-month period
(01.2021- 10.2023). To assess the prognostic performance of NLR we used the area under the receiver
operating characteristics (AUROC) curves.
Results: Of a total of 84 patients, nine (10.7%) died. Using ROC Curve analysis we found that
NLR has an excellent prognostic ability and outperformed systemic immune inflammation index
(SII), platelet to lymphocyte ratio (PLR), quick- sequential organ failure (qSOFA) score and systemic
inflammation response syndrome (SIRS) (AUROC = 0.904 vs 0.782 vs 0.749 vs 0.747 vs
0.676, respectively) in outcome prediction. An optimal threshold NLR > 9.88 x 109/L for prognostication
of death was identified with a sensitivity of 85.7% and a specificity of 83.6%.
Conclusion: In pleural empyema the neutrophil to lymphocyte ratio demonstrates excellent ability
to predict the unfavorable outcome.