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Am J Emerg Med. 2018 Oct 30. pii: S0735-6757(18)30888-X. doi: 10.1016/j.ajem.2018.10.057. [Epub ahead of print]

The neutrophil-lymphocyte count ratio as a diagnostic marker for bacteraemia: A systematic review and meta-analysis.

Author information

1
Department of Critical Care Medicine, Tianjin Medical University First Center Clinical College, Tianjin, People's Republic of China.
2
Department of Critical Care Medicine, Tangdu Hospital, Second Affiliated Hospital of Air Force Military Medical University, Xian, People's Republic of China.
3
Department of Critical Care Medicine, Tianjin First Center Hospital, Tianjin, People's Republic of China; Tianjin First Center Hospital Emergency Medical Research Institute, Tianjin, People's Republic of China.
4
Department of Critical Care Medicine, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.
5
Department of Critical Care Medicine, Tianjin First Center Hospital, Tianjin, People's Republic of China; Tianjin First Center Hospital Emergency Medical Research Institute, Tianjin, People's Republic of China. Electronic address: yongqiangwang1962@sina.com.

Abstract

BACKGROUND:

Bacteraemia is a common cause of increased morbidity and mortality in critically ill patients, but its early diagnosis and identification are complicated. The neutrophil-lymphocyte count ratio (NLCR) has been suggested as a useful indicator for the diagnosis of bacteraemia. We performed this meta-analysis to investigate the diagnostic accuracy of the NLCR for bacteraemia.

METHODS:

We searched the PubMed, Embase, Web of Science, and Cochrane Library databases for this meta-analysis. We calculated individual and pooled sensitivities and specificities. I2 statistics and Cochran's Q test were used to evaluate heterogeneity, and the cause of heterogeneity was explored with sensitivity analyses.

RESULTS:

In total, 8 of 1086 eligible articles were included in the present meta-analysis. The pooled analyses revealed that the diagnostic accuracy of the NLCR in terms of its bacteraemia sensitivity was 0.723 [95% CI: 0.660, 0.777], and its specificity was 0.596 [95% CI: 0.556, 0.634]. The area under the summary receiver operating characteristic curve was 0.69 [95% CI 0.65-0.73].

CONCLUSION:

The NLCR is an easy-to-collect marker for bacteraemia. However, the NLCR is inadequate, and only a combination of multiple biomarkers will improve its diagnostic accuracy for bacteraemia.

KEYWORDS:

Bacteraemia; Diagnosis; Meta-analysis; Neutrophil-lymphocyte count ratio

PMID:
30413366
DOI:
10.1016/j.ajem.2018.10.057

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