Reyes-Gálvez JA, Gracida- Mancilla NI, Enríquez-Santos D, Carrillo-Esper R

Language: Spanish
References: 16
Page: 41-47
PDF size: 783.49 Kb.

ABSTRACT

Background: Abdominal sepsis is a clinical entity that is on the increase and its mortality depends mainly on clinical evaluation, timely diagnosis and an early treatment. Currently, there are different ways of measuring the severity and mortality of sepsis, especially with biomarkers and scales; however, the scales, laboratories and biomarkers are not available in many health centers in our country because especially of the high cost. Therefore, it is necessary to search for easy, quick and low-cost methods to measure severity and mortality of this entity.
Objective: To assess if neutrophil-lymphocyte ratio is an adequate marker of prognosis and severity in sepsis.
Material and Method: A retrospective, observational, correlational, analytical study was conducted with patients of the Integral Attention of the Abdominal Sepsis Clinic (IAASC) of the Hospital General de Mexico, from July 2013 to July 2014, with diagnosis of abdominal sepsis and submitted to surgery for correction of the abdominal infectious focus. APACHE II scale and the neutrophil-lymphocyte ratio were applied at entering to the Emergency Room, as well as the discharge state as alive or dead. APACHE II scale was considered to divide the cases in slight (less than 14) and severe (higher than 15).
Results: There were included 193 cases. The finding of the adjusted analysis was that the neutrophil-lymphocyte ratio is a diagnostic test with low correlation to the severity of abdominal sepsis having an area under the curve of 0.660, with sensitivity of 44% and specificity of 79% and for mortality has an area under the curve of 0.702, and sensitivity of 45% and specificity of 77% having both a breakpoint of 18 (p ‹0.05).
Conclusion: The neutrophil-lymphocyte ratio is a low global statistical power test with low sensitivity and specificity to evaluate the severity and mortality of patients with abdominal sepsis.

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