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All Journal Journal of Biomedicine and Translational Research Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Notopuro, Paulus Budiono
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Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology

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The Difference in Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and Lactate Levels Between Sepsis and Septic Shock Patients Who Died in The ICU Rachmawati, Dwi; Utariani, Arie; Notopuro, Paulus Budiono; Semedi, Bambang Pujo
Indonesian Journal of Anesthesiology and Reanimation Vol. 5 No. 2 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V5I22023.64-71

Abstract

Introduction: Sepsis and septic shock are organ dysfunctions caused by the dysregulation of the body's response to infection and are the most common causes of death. Objective: This study aims to describe the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and lactate levels in patients with sepsis and septic shock who died in the Intensive Care Unit (ICU). Methods: An observational retrospective study was conducted by examining the medical record data of sepsis and sepsis shock patients who were hospitalized in the ICU of Dr. Soetomo General Academic Hospital Surabaya from January to December 2019. Results: The study sample was 28 patients: 16 with sepsis and 12 with septic shock. Fifteen patients (53.6%) were women. The patients' mean age was 53.18 ± 13.61 years, and most patients (8 patients, 28.6%) belonged to the late adult age group (36-45 years). The most common comorbidities were diabetes mellitus and hypertension (30.8%). The highest incidence of infection in both groups occurred in the lungs (42.9%). Most of the patients had high SOFA scores, in the moderate (7-9) to severe (≥ 10) category (39.3%). Almost all patients (82.1%) were treated for less than one week. The hematological examination within the first 24 hours showed a leukocyte value of 16,995 (Leukocytosis) and a platelet value of 279,500 (Normal). The NLR of septic shock patients (31.38±55.61) was higher than the NLR of sepsis patients (23.75±22.87). The PLR of septic shock patients (534.02±1000.67) was lower than the PLR of patients (802.93±1509.89). Lastly, the lactate levels in septic shock patients (3.84±1.99) were higher than in sepsis patients (1.97±1.06). Conclusion: There were no significant differences in the NLR and PLR values "‹"‹between sepsis and septic shock patients, but there were significant differences in their initial lactate levels.
Correlation of Neutrophil-Lymphocyte Ratio, Monocyte-Lymphocyte Ratio, and Platelet-Lymphocyte Ratio with Stunting in Children Stanpo, Gwyneth Trixie; Notopuro, Paulus Budiono; Widjaja, Nur Aisiyah
Journal of Biomedicine and Translational Research Vol 11, No 3 (2025): December 2025
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v11i3.28088

Abstract

Background: Globally, stunting affected approximately 148 million children under five in 2022. Chronic infection contributes to stunting through immune hyperactivation and excessive cytokine release. Since anthropometric assessments are prone to errors and may not accurately reflect the underlying inflammatory status, common systemic inflammatory markers, such as the Neutrophil-Lymphocyte Ratio (NLR), Monocyte-Lymphocyte Ratio (MLR), and Platelet-Lymphocyte Ratio (PLR), can serve as alternatives. These markers are simple, affordable, and accessible in every health center.Objective: To analyze the correlation of NLR, MLR, and PLR with stunting.Methods: A cross-sectional study involving pediatric patients aged 1-5 years from the Nutrition and Metabolic Outpatient Clinic of Dr. Soetomo Regional Hospital in Surabaya from 2022 to 2023. Forty-one samples met the inclusion and exclusion criteria. Data on NLR, PLR, MLR, and other hematological variables were obtained from the patients' hematology profiles. Group differences, correlations, and diagnostic performance were analyzed using Kruskal–Wallis, Spearman, and ROC methods, respectively.Results: Forty-one subjects were obtained and divided into three groups: 21 (51.2%) normal, 10 (24.4%) stunted, and 10 (24.4%) severely stunted. RBC and lymphocytes significantly increased in normal patients, whereas neutrophils, platelets, NLR, MLR, and PLR significantly increased in severely stunted patients. NLR, MLR, and PLR differed significantly between normal and stunted children (p =<0.001; p =0.002; and p =<0.001, respectively) and showed positive correlations between the NLR (p =<0.001; r =0.687), MLR (p =<0.001; r =0.558), and PLR (p =<0.001; r =0.784) with stunting. At cutoff values of 0.844 (NLR), 88.527 (PLR), and 0.174 (MLR), their AUCs were 0.90, 0.95, and 0.82, with sensitivities of 75%, 80%, and 60%, respectively.Conclusion: NLR, MLR, and PLR significantly differ among normal, stunted, and severely stunted children, showing positive associations with stunting. These markers, particularly PLR, may serve as a practical screening tool, warranting further validation through larger studies.
Co-Authors Fachry Abda El Rahman Nur Aisiyah Widjaja, Nur Aisiyah Semedi, Bambang Pujo Stanpo, Gwyneth Trixie Utariani, Arie