Clinical value of neutrophil/albumin ratio in predicting prognosis of children with severe sepsis

Objective To assess the value of neutrophil/albumin (NEU/Alb) ratio in predicting prognosis of children with severe sepsis. Methods One hundred and fi fty-eight cases with severe sepsis treated in Haikou Maternal and Child Health Care Hospital from January 2014 to March 2017 were divided into survival group (n=113) and death group (n=45) according to their 28-day survival. The changes of neutrophil count (NEU), albumin (Alb) and NEU/Alb ratio at 0 hour, 24 hours, and 72 hours after treatment in two groups were detected, and the APACHEⅡ and PCIS scores at admission were recorded. The evaluation value of NEU, Alb and NEU/Alb in predicting the prognosis of children with severe sepsis was analyzed by ROC curve. Correlation between NEU/Alb and APACHEⅡ, PCIS scores in dead children was analyzed by Pearson correlation analysis. Results NEU and NEU/Alb in the death group were significantly higher than those in the survival group at 0 hour, 24 hours and 72 hours after treatmentNEU(×10⁹/L):(12.46±4.05) vs (9.82±3.37), (15.74±4.80) vs (8.56±3.20), (18.42±5.27) vs (6.38±2.45); NEU/Alb:(0.52±0.20)vs (0.35±0.13), (0.74±0.26) vs (0.33±0.14), (1.05±0.42) vs (0.16±0.08), all P< 0.05. Alb in the death group was significantly lower than that in the survival group at 0 hour, 24 hours and 72 hours after treatmentAlb(g/L):(25.18±4.72) vs (28.14±5.20), (22.24±4.30) vs (30.15±5.63), (19.38±3.81) vs (36.28±6.94), all P< 0.05. The ROC curve analysis showed that NEU/Alb at 72 hours after treatment predicted prognosis of severe sepsis children with greatest AUC (95% CI)0.908 (0.848-0.971), sensitivity(90.4%) and specificity (84.0%) compared with other indicators (all P< 0.05). Correlation analysis showed that 72 hours NEU/Alb was positively correlated with APACHEⅡscore (r=0.708, P< 0.01), and negatively correlated with PCIS score (r=-0.682, P< 0.01). Conclusion The change of NEU/Alb ratio is associated with the severity and prognosis of children with severe sepsis, and the 72 hours NEU/Alb ratio can optimally predict the prognosis of children with severe sepsis.