Neutrophil to Lymphocytic Count and SOFA Score as Prognostic Marker in Patient With Sepsis

  • Prasanna Rajbhandari Department of General Practice and Emergency Medicine, IOM, TUTH
  • Yagya Laxmi Shakya Department of General Practice and Emergency Medicine, IOM, TUTH
  • Anup Raj Upreti Clinical Pharmacist, Nepal Medical College


Introduction: Neutrophil-to-lymphocyte ratio is calculated from the white cell differential blood count, a marker that has been used as a prognostic index when assessing patients suffering from several clinical syndromes, including sepsis. The aim of this study was to find out the relationship between Neutrophilto- lymphocyte ratio and the commonly used severity score of SOFA in a population of emergency admitted adult patients with sepsis as prognostic marker in a tertiary center.

Methods: This observational analytical study was conducted in the Emergency Department of the Tribhuwan University Teaching Hospital based on data extracted from 155 patients consecutively enrolled, suffering from sepsis of multiple origin. The study period was from June 2017 until August 2017. Neutrophil-to-lymphocyte ratio and SOFA score were calculated as prognostic marker in septic patients upon hospital admission.

Results: Out of 144 patients included in the study, mean age of patients was 51.02 ± 20.96, among which 144 (32.6%) were male and 144 (67.3%) were female, most common source of infection was respiratory system in 45 patients followed by gastrointestinal system in 38 patients , the overall 28 day mortality was observed in 144 (22.92%). There was a strong correlation between SOFA score and NRL (p < 0.05). The sensitivity of NRL was 78.8% and specificity 73.9% at a cut off value of 8.75 and sensitivity of SOFA was 84.8% and specificity 73% at a cut off value of 6.5.

Conclusions: The Neutrophil-to-lymphocyte ratio and SOFA score both proved to be similar as a simple infection marker with discriminatory capacity in predicting prognosis in infectious admissions.

Keywords: neutrophil-to-lymphocyte ratio; prognosis; sepsis; SOFA score

Original Article