Can the neutrophil to lymphocyte ratio, determined in the whole blood count, be used as a mortality marker in patients with pulmonary thromboembolism ?

Objective: Acute pulmonary thromboembolism (APTE) is one of the life-threatening cardiovascular diseases. Following the diagnosis, it has a broad range of severity and a wide spectrum. Its mortality and morbidity vary depending on its clinical scope and the site of involvement. Neutrophil / lymphocyte ratio (NLR) has previously been studied in many cardiovascular disease processes as an indicator of inflammation and marker of mortality. The aim of our study is to determine the correlation between NLR and the 30-day mortality in APTE. Materials and Methods: 160 APTE patients who applied to the emergency department of Bagcilar Education and Research Hospital between January 2011 and June 2013 were determined retrospectively and hemogram parameters at the time of application were recorded. It was ensured in the selection of patients that all patients had a final diagnosis supported by computed tomography. APTE patients; It was divided into two groups in terms of those who died (n:28) and survived (n:120) within 30 days. Low, medium and high risk APTE patients in both groups were compared in terms of NLR. The utility of NLR as a marker of mortality was investigated in patients with pulmonary embolism Results: NLR was significantly higher in the deceased group (11.40 ± 4.24 vs 18.33 ± 9.06, p < 0.001). It had 57 % sensitivity and 89 % specificity for prediction of mortality (Area Under Curve: 0.736, 95% CI: 0.619–0.853, p < 0.001) in patients with pulmonary embolism. In the multivariate logistic regression analysis; NLR was found to be signifant independent predictor of the 30-day mortality (Odds: 1.132 (1.031-1.243, CI 95%), p=0.009). Conclusion: NLR plays a strong role in determining 30-day mortality in APTE patients. Key Words: Leukocyte Count; Pulmonary embolism; Mortality