Neutrophil-to-lymphocyte ratio [NLR] as a promising prognostic marker in critically Ill septic patients

Background: NLR is advantageous in regard to simplicity, low cost, and availability compared to many other previously proposed biomarkers, which makes it promising for diagnostic clinicians. Several studies have reported that the NLR is useful in various clinical situations.Objective: To determine whether NLR obtained from complete blood count (CBC) and with simple calculation can be used to predict mortality in patients with sepsis and septic shock in the ICU in comparison with intensive care unit (ICU) severity scores.Patients and methods: This prospective trial was carried out on 84 ICU cases with severe sepsis, who were admitted to Specialized Medical Hospital ICUs from June 2020 to June 2021.Results: There was statistically significantly higher systolic blood pressure (mmHg), mean arterial pressure, rate pressure product *10^3, EF, INR, RBS, PH, HCO3, L *10^3, platelet count, CRP on admission, ABACHEII score, SOFA score on admission, duration of hospital stay (days), and a statistically significantly lower age (years), diastolic blood pressure (mmHg), heart rate, respiratory rate (RR), GCS, serum creatinine (mg/dl), serum albumin, serum bilirubin, Na, K, total leucocytic count *10^3, N *10^3, in group B NLR >10 vs. group A NLR≤ 10.Conclusion: Neutrophil to lymphocyte ratio is a cheap and rapidly available predictor of sepsis and has shown a significant correlation with other relatively expensive and non-rapidly existing markers of inflammation and sepsis with comparable efficacy with ICU severity scores [SOFA and APACHE II]

Serum cystatin C and serum lactate levels as diagnostic and prognostic markers in acute kidney injury in critically ill patients

Background: The early diagnosis of AKI in patients with sepsis would assist in more-effective care for these patients, AKI has traditionally been detected and defined by measuring surrogates of kidney-filtration function, such as plasma creatinine (pCr), urea, and, recently, plasma cystatin C (pCysC). Aim and objectives: The main aim of this study was to assess the accuracy of serum cystatin C and serum lactate as markers for diagnosis and prognosis of acute kidney injury in critically ill patients. Subjects and methods: This prospective case control study was conducted at critical care units of Specialized Medical Hospital, Mansoura University. This study was conducted on enrolled 87 critically ill-patients divided into three groups: Group A: Control (Non-AKI) group: N = 16. Group B: AKI (Recovered) group: N = 28. Group C: AKI (Non-recovered) group: N = 43. Results: It was showed a statistically significant positive correlation of low strength between serum cystatin C levels and MV duration (days), ICU-stay (days), SOFA score, serum creatinine, and serum total bilirubin, and a statistically significant negative correlation of low strength between serum cystatin C levels and both RBG and PaCO2