The diagnostic value of complete blood parameters in determining the severity of community-acquired pneumonia in children

Year 2022, , 1592 - 1599, 25.10.2022

Deniz Güven , Fatih Mehmet Kışlal

https://doi.org/10.32322/jhsm.1171374

Cited By: 1

Abstract

Aim: In children, community-acquired pneumonia (CAP) has a high mortality and morbidity rate. Platelet, neutrophil, lymphocyte, monocyte, eosinophil, red cell distributions width (RDW), mean platelet volume (MPV), platelet distributions width (PDW), platelet to lymphocyte ratio (PLR), and neutrophil to lymphocyte ratio (NLR) have all been suggested as markers of systemic infection and inflammation. Several research, however, have centered on the clinical significance of blood parameters in pediatric CAP. We aim to determine the diagnostic value of complete blood parameters for CAP and to look into their relationship to disease severity.
Material and Method: A retrospective, the cross-sectional study enrolled children aged 3 months to 18 years who were diagnosed with CAP at Ankara Atatürk Sanatorium Training and Research Hospital's pediatrics clinics between January 2018 and June 2021, as well as age-matched healthy children. CAP case definition was made according to the CAP case definition defined by the World Health Organization (WHO). Patients were evaluated according to the criteria of WHO and British Thoracic Society 2011 guidelines as severe and mild CAP.
Results: 400 CAP and 400 control patients were included in the study. The mean age of the CAP group was 2.40±3.20 years and the control group was 2.38±3.17 years. Eosinophil, hemoglobin, MPV, PDW and PLR values of the CAP group was statistically significantly lower; leukocytes, lymphocyte, monocyte, neutrophil, basophil, platelet, RDW, and NLR levels of the CAP group were higher than the control group (p<0.05). 30.3% of the CAP patients had severe disease. The mean age of the severe group was 2.92±3.80 and 2.17±2.88 in the mild group. The ratio of males in the CAP group was 62%, while 80.2% in severe, 54.1% in the mild group (p<0.001).The mean hospitalization length for the severe group was 6.16±2.00 days and 4.89±1.78 days for the mild group (p<0.001). CRP, neutrophils, monocyte, eosinophil, and NLR levels were statistically significantly higher in patients in the severe group than the mild group (p<0.001). In ROC analysis, the area under the characteristic curve (AUC) for CRP, monocyte, neutrophils, eosinophil, and NLR was calculated as 0.574, 0.569, 0.601, 0.628, and 0.583, respectively and all found statistically significant (p<0.001). Correlation analysis revealed that CRP had a positive correlation with neutrophil count (r=0.231, p=0.011) and NLR (r=0.221, p=0.015) in the severe COP patients.
Conclusion: Increased neutrophils, eosinophil, monocytes, CRP, and NLR, were predicting the severity of CAP. NLR and neutrophils had a significant correlation with CRP and potential parameters for evaluating the severity of CAP disease.

Keywords

Community-acquired pneumonia, children, neutrophils, neutrophil-to-lymphocyte ratio, monocyte, eosinophil, diagnostic value

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