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J Korean Soc Emerg Med > Volume 31(6); 2020 > Article
Journal of The Korean Society of Emergency Medicine 2020;31(6): 562-569.
응급실로 내원한 급성 신우신염 여성 환자의 중증도 예측을 위한 호중구와 림프구의 수치비의 역할
송백호1 , 박상현1 , 소병학2 , 김수현3 , 주종호3 , 최승필3 , 오재훈3
1가톨릭대학교 여의도성모병원 응급의학과
2성빈센트병원 응급의학과
3은평성모병원 응급의학과
The role of the neutrophil-to-lymphocyte ratio for the prediction severity in women with acute pyelonephritis in the emergency department
Back Ho Song1 , Sang Hyun Park1 , Byung Hak So2 , Soo Hyun Kim3 , Jongho Zhu3 , Seung Pill Choi3 , Jae Hun Oh3
1Department of Emergency Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Department of Emergency Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
3Department of Emergency Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Correspondence  Jae Hun Oh ,Tel: 02-2090-4603, Fax: 02-2030-2923, Email: emojh@catholic.ac.kr,
Received: June 27, 2020; Revised: July 22, 2020   Accepted: August 5, 2020.  Published online: December 30, 2020.
It is difficult to predict medical outcomes for acute pyelonephritis (APN) in women. A delay in diagnosis and treatment results in rapid progression to circulatory collapse, multiple organ failure, and death. We investigated the value of procalcitonin (PCT) and neutrophil-to-lymphocyte ratio (NLR) in APN patients hospitalized through the emergency room.
We retrospectively evaluated women with APN presenting in the emergency room from January 2014 to May 2018. Inflammatory biomarkers, including PCT and NLR, were measured, and the severity of pyelonephritis was assessed using the Surviving Sepsis Campaign definitions (Sepsis-3). Multivariable logistic regression analysis was used to evaluate the risk factors associated with septic shock and the prediction for septic shock was compared using a receiver operating characteristic (ROC) curve.
A total of 357 female patients with APN were included. The median level of PCT and NLR was higher in the septic shock group compared with other groups. Multivariate logistic regression analysis showed that age and PCT were risk factors for septic shock. When the ROC curve of septic shock was compared, PCT showed a higher area under the curve than NLR (NLR 0.65 vs. PCT 0.80).
The initial NLR in the emergency room showed significant differences depending on the severity as classified by Sepsis-3 definitions. However, NLR was not found to be associated with septic shock in female patients with APN.
Key words: Neutrophil count; Lymphocyte count; Acute pyelonephritis; Neutrophil to lymphocyte ratio
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