ABSTRACT
Background: Acute kidney injury (AKI) is frequent in sepsis (25 to 51%), with high mortality (40 to 80%) and long-term complications. Despite its importance we do not have accessible markers in intensive care. In other entities (post-surgical and COVID-19) the neutrophil/lymphocyte and platelet (N/LP) ratio has been associated with acute kidney injury;however, this relationship has not been studied in a pathology with a severe inflammatory response such as sepsis. Objective: To demonstrate the association between N/LP with AKI secondary to sepsis in intensive care. Material and methods: Ambispective cohort study in patients over 18 years who were admitted to intensive care with a diagnosis of sepsis. The N/LP ratio was calculated from admission up to the seventh day and up to the diagnosis of AKI and outcome. Statistical analysis was performed with chi squared test, Cramer's V and multivariate logistic regression. Results: Out of the 239 patients studied, the incidence of AKI developed in 70%. 80.9% of patients with N/LP ratio > 3 had AKI (p < 0.0001, Cramer's V 0.458, OR 3.05, 95% CI 1.602-5.8) and increased renal replacement therapy (21.1 vs. 11.1%, p = 0.043). Conclusion: N/LP ratio > 3 has a moderate association with AKI secondary to sepsis in the intensive care unit. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
ABSTRACT
BACKGROUND: Acute respiratory distress syndrome, due to SARS-CoV-2, is a worldwide health problem. The neutrophil-lymphocyte index allows risk stratification in patients with severe and poor prognostic data, since it reflects the inflammatory state. OBJECTIVE: To determine whether the Neutrophil-Lymphocyte Index delta predicts mortality in patients with COVID-19. MATERIAL AND METHODS: We conducted a longitudinal, comparative study in patients with COVID-19, older than 18 years, admitted to the ICU. We evaluated HAS, DM, obesity, COPD, asthma, PaO2/FiO2, tomographic severity. On admission and on days 3 and 7 we measured Neutrophil-Lymphocyte Index, SOFA and APACHE score. For statistical analysis, we performed ROC and Kaplan-Meyer curves. RESULTS: We included 180 patients with COVID-19, 63 died (35%). Delta INL1(Day1-day3)>4.11 was associated with mortality (AUC:0.633);sensitivity 55.56% and specificity 77.78%, CI95 0.55-0.70, for delta INL2 (Day1-day7)>8.95 (AUC:0.623);sensitivity 44.44% and specificity 84.62%, CI95 0.54-0.69. Difference in survival was observed for Delta1. SOFA scale >6, was associated with more days of mechanical ventilation and lower PaO2/FiO2 (p<0.001). CONCLUSIONS: INL delta between the day of ICU admission and the 3rd day of evolution is a predictor of mortality in critically ill patients.