Efficacy of Prognostic Scoring Systems and Neutrophil-to- Lymphocyte Ratio (NLR) Among Critically Ill Elder Sepsis Patients
Abstract
Objectives: Several scoring models and biomarkers are available to predict survival among critically ill patients. However, their accuracy among
older adults with sepsis has been questioned. In this study, we aimed to evaluate the currently used prognostic scoring scales and neutrophil-tolymphocyte
ratio (NLR) in the prediction of survival among older adults with sepsis.
Materials and Methods: The study prospectively included older adults who were admitted to the intensive care unit (ICU) with sepsis. On admission,
Acute Physiology And Chronic Health Evaluation (APACHE)-II, Sequential (sepsis-related) Organ Failure Assessment (SOFA), Glasgow coma scale
(GCS) score, and NLR were calculated. By the end of a 28-day follow-up period, survivors and non-survivors were compared for the study parameters.
Results: Overall, the data of 36 patients were analyzed (mean age: 80.00±6.37 years, female: 58.3%). The rate of mortality was 47.3% (n=17). The
mean SOFA score and the median NLR on admission were significantly lower in survivors [SOFA: 10.37±2.91, and NLR: 9.64 (11.25)] vs non-survivors
[SOFA: 12.82±3.21 and NLR: 14.95 (35.53)] (p<0.05) but the mean APACHE-II and the median GCS score were comparable. Using ROC curve analysis,
we determined that only the SOFA score and NLR could predict mortality.
Conclusion: The present study showed that, among older adults with sepsis admitted to the ICU, baseline SOFA score and NLR but not APACHE-II
or GCS score could successfully predict mortality. Further studies are required to evaluate the utility of existing prognosis scales in older people.
Keywords
Organ Dysfunction Scores, Sepsis, APACHE, Survival, Intensive Care Units, Aged
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