To evaluate the neutrophil-to-lymphocyte ratio (NLR) as a practical surrogate for monocyte HLA-DR (mHLA-DR) in assessing immunosuppression in septic patients, highlighting its potential to improve clinical outcomes.
Key Findings:
NLR > 10 correlates with mHLA-DR < 8000 AB/C, indicating immunosuppression and potential clinical implications.
64% concordance between NLR and mHLA-DR classifications, suggesting NLR's utility in clinical settings.
NLR integrates features of neutrophilia, high immature neutrophil proportion, and lymphopenia, reflecting complex immune responses.
Interpretation:
NLR serves as a practical, accessible marker for identifying patients at risk of immunosuppression, with implications for clinical decision-making, although it does not fully replace mHLA-DR.
Limitations:
NLR may not accurately reflect underlying leukocyte abnormalities like profound neutropenia or lymphopenia; sample size and cohort diversity should be considered.
Further validation and establishment of clinically relevant thresholds are needed.
Conclusion:
NLR is a promising, readily implementable marker for assessing immune status in critically ill patients, warranting further research for validation and potential integration into clinical practice.
