ĐẶC ĐIỂM TỶ SỐ BẠCH CẦU TRUNG TÍNH TRÊN BẠCH CẦU LYMPHO (NLR) VÀ MỘT SỐ XÉT NGHIỆM HUYẾT HỌC, SINH HÓA, VI SINH Ở NGƯỜI BỆNH SEPSIS TẠI BỆNH VIỆN TRUNG ƯƠNG QUÂN ĐỘI 108

Abstract

Objective: To describe the neutrophil-to-lymphocyte ratio (NLR) and selected hematological, biochemical and microbiological parameters in patients with sepsis at 108 Military Central Hospital.

Subjects and methods: A retrospective cohort study of 92 adult patients with sepsis (Sepsis-3 criteria) treated in 2024. Complete blood count, procalcitonin (PCT), biochemical tests and blood cultures obtained within 6 hours of sepsis diagnosis were retrieved. NLR was compared by severity and 28-day outcome using the Mann–Whitney U test; discrimination for 28-day mortality was assessed by the area under the ROC curve (AUC).

Results: The median age was 70 years (IQR 55.8–78); 67.4% were male. Septic shock was present in 60.9% and 28-day mortality was 40.2%. Blood cultures were positive in 34.8%; among them, Gram-negative bacteria accounted for 75.0%, E. coli for 40.6% and K. pneumoniae for 15.6%. The median neutrophil and lymphocyte counts were 13.5 and 0.9 G/L; 46.7% of patients had lymphopenia. The median NLR was 13.5 (IQR 8.7–19.8), and 68.5% (95% CI: 58.4–77.1%) had an NLR > 10. The median PCT was 46.3 ng/mL and SOFA score 9. NLR was higher in septic shock than in sepsis without shock (15.9 vs 10.8; p = 0.008) and in 28-day non-survivors than in survivors (17.6 vs 11.7; p = 0.003); its AUC for 28-day mortality was 0.71 (95% CI: 0.60–0.81).

Conclusion: Patients with sepsis in this cohort were severely ill, and Gram-negative bacteria predominated among culture-positive cases. At diagnosis, NLR was markedly elevated (median 13.5; 95.7% had NLR ≥ 5), reflecting neutrophilia with lymphopenia. NLR was higher in septic shock and in 28-day non-survivors, but its discrimination for mortality was only moderate; NLR should be interpreted together with clinical severity scores.