Predictive Value of Neutrophil-to-Lymphocyte Ratio on Hospital Mortality of Patients with Community-Acquired Pneumonia

Authors

  • Md Khairul Islam Junior consultant, Department of Medicine, Dhaka Medical College Hospital, Dhaka
  • Zakir Hossain Junior consultant, OSD, DG health, Dhaka
  • Fahima Sharmin Hossain Indoor Medical Officer, Department of Obstetrics and Gynecology, Dhaka Medical College
  • Nur Alam Indoor Medical Officer, Department of Hepatology, Dhaka Medical College, Dhaka
  • Abul Kalam Md Sajedur Rahman Associate professor, Department of Medicine, Dhaka Medical College Hospital, Dhaka
  • Md Mamunur Rashid Junior consultant Medicine, National Gastroliver institute and hospital, Dhaka
  • Mohammad Zakaria Al Aziz Associate professor, Department of Medicine, Dhaka Medical College Hospital
  • Md Monir Uz Zaman Professor of Medicine, Department of Medicine, Mugda Medical College, Dhaka

DOI:

https://doi.org/10.3329/jom.v26i2.84356

Keywords:

Community-acquired pneumonia, Neutrophil-to-lymphocyte ratio, Hospital mortality, Biomarkers, Bangladesh

Abstract

Background: The neutrophil-to-lymphocyte ratio (NLR), a cheap blood parameter, has shown promise as a predictor of adverse outcomes in severe infections. However, its utility in predicting mortality among patients with severe CAP in Bangladesh remains underexplored.

Objective: This study aimed to assess the predictive value of admission NLR for in-hospital mortality among patients with CAP admitted to a tertiary care hospital in Bangladesh.

Methods: This prospective, observational study was conducted from July 2023 to June 2024 at Dhaka Medical College Hospital. One hundred eight patients aged 18 years or older with a clinical and radiological diagnosis of CAP were included. Exclusion criteria were hospital-acquired pneumonia, pulmonary tuberculosis, malignancy, immunosuppression, and HIV infection. Baseline demographic, clinical, and laboratory data were collected. NLR was calculated from routine complete blood counts, and a predefined cutoff of

7.12 was used for stratification. In-hospital mortality was the primary outcome. Logistic regression and ROC curve analyses were performed to evaluate the predictive performance of NLR.

Results: The overall in-hospital mortality rate was 12.0%. Patients with an NLR ³7.12 had a significantly higher mortality risk (OR: 1.63; 95% CI: (1.07–3.82); p = 0.040). Multivariate analysis identified NLR as an independent predictor of mortality (adjusted OR: 1.34; 95% CI: 1.02–1.75; p = 0.033), along with chronic kidney disease (adjusted OR: 5.63; 95% CI: 1.15–27.60; p = 0.033) and cardiac failure (adjusted OR: 36.87; 95% CI: 5.57–244.22; p < 0.001). ROC analysis demonstrated excellent predictive performance for NLR, with an area under the curve (AUC) of 0.905.

Conclusion: Elevated admission NLR is a significant independent predictor of in-hospital mortality in patients with CAP. Given its simplicity, cost-effectiveness, and widespread availability, NLR can be a valuable prognostic tool in resource-constrained settings, complementing traditional clinical scores like CURB-65.

J MEDICINE 2025; 26(2): 110-116

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Published

2025-09-28

How to Cite

Islam, M. K., Hossain, Z., Hossain, F. S., Alam, N., Rahman, A. K. M. S., Rashid, M. M., … Zaman, M. M. U. (2025). Predictive Value of Neutrophil-to-Lymphocyte Ratio on Hospital Mortality of Patients with Community-Acquired Pneumonia. Journal of Medicine, 26(2), 110–116. https://doi.org/10.3329/jom.v26i2.84356

Issue

Vol. 26 No. 2 (2025)

Section

Original Articles

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