Background Even though extensive investigation has been done to understand better the pathophysiology, early detection, and clinical management of sepsis, the death rate for sepsis cases in ICUs is still alarmingly high. This study aimed to assess the neutrophil-to-lymphocyte-and-platelet ratio (N/LP ratio) as a predictor of death in septic acute kidney injury (AKI) cases. Patients and methods A total of 150 patients with septic AKI have been recruited in the present study. Out of those cases, 50/150 (33.3%) patients died, and 100/150 (66.7%) patients improved. All cases underwent a comprehensive history and clinical assessment. Routine blood tests and blood cultures were done in all patients with calculation of the N/LP ratio. Results The survivor group had a significantly lower mean age (51.23 ± 8.56 vs. 60.75 ± 9.60 years; P <0.001) and a lower frequency of mechanical ventilation (7 vs. 22%; P =0.01). A significantly reduced serum albumin (3.10 ± 0.22 vs. 3.98 ± 0.20 g/dl; P <0.001) and higher baseline N/LP ratio (12.87 ± 1.09 vs. 6.78 ± 2.10; P <0.001) and follow-up N/LP (5.15 ± 1.34 vs. 15.67 ± 2.89; P <0.001) among the nonsurvivor group. The N/LP ratio showed a significant positive correlation with Acute Physiology and Chronic Health Examination-II ( r =0.56), Sequential Organ Failure Assessment ( r =0.69), and length of stay ( r =0.23). Predictors of death in cases that had septic acute kidney damage were mechanical ventilation odds ratio (OR)=2.45, N/LP ratio (OR=3.56), low serum albumin (OR=1.33), Acute Physiology and Chronic Health Examination-II (OR=2.34), and Sequential Organ Failure Assessment (OR=2.79). Using receiver operating characteristic curve analysis, at a cutoff point more than 10.19, it was found that the N/LP ratio had 91.2% overall accuracy in the prediction of death in cases that had septic AKI. Conclusion Elevated N/LP level could be a predictor for the development of AKI among septic patients at the ICU admission. It was also independently related to in-hospital death in septic-AKI cases. Large multicenter studies are recommended.
Azoz et al. (Thu,) studied this question.