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Abstract：
We aimed to assess the prognostic role of the neutrophil/lymphocyte ratio (NLR) in community-acquired pneumonia (CAP) via a single-center retrospective cohort of hospitalized adult patients from 1/2009 to 12/2019. Patients were dichotomized into lower NLR (≤12) and higher NLR (>12). The primary outcome was mortality. ICU admission and hospital- and ICU-free days were secondary outcomes. The pneumonia severity index (PSI) and the NLR\'s ability to predict outcomes was also tested. An NLR ≤12 was observed in 2513 (62.2%) patients and >12 in 1526 (37.8%). After adjusting for PSI, the NLR was not associated with hospital mortality (odds ratio [OR] 1.115; 95% confidence interval [CI] 0.774, 1.606; p = 0.559), but it was associated with a higher risk of ICU admission (OR 1.405; 95% CI 1.216, 1.624; p < 0.001). The PSI demonstrated acceptable discrimination for mortality (area under the receiver operating characteristic curve [AUC] 0.78; 95% CI 0.75, 0.82) which was not improved by adding the NLR (AUC 0.78; 95% CI 0.75, 0.82, p = 0.4476). The PSI\'s performance in predicting ICU admission was also acceptable (AUC 0.75; 95% CI 0.74, 0.77) and improved by including the NLR (AUC 0.76, 95% CI 0.74, 0.77, p = 0.008), although with limited clinical significance. The NLR was not superior to the PSI for predicting mortality in hospitalized CAP patients.
摘要：
我们旨在通过2009年1月至2019年12月住院成年患者的单中心回顾性队列，评估中性粒细胞/淋巴细胞比率（NLR）在社区获得性肺炎（CAP）中的预后作用。将患者分为较低的NLR（≤12）和较高的NLR（>12）。主要结果是死亡率。ICU入院和无ICU天数是次要结局。还测试了肺炎严重度指数（PSI）和NLR预测结果的能力。在2513例（62.2%）患者中观察到NLR≤12，在1526例（37.8%）中观察到>12。调整PSI后，NLR与住院死亡率无关(比值比[OR]1.115;95%置信区间[CI]0.774,1.606;p=0.559),但与ICU入住风险较高相关(OR1.405;95%CI1.216,1.624;p<0.001).PSI显示出可接受的死亡率差异(接受者工作特征曲线下面积[AUC]0.78;95%CI0.75,0.82),其通过添加NLR(AUC0.78;95%CI0.75,0.82,p=0.4476)没有改善。PSI在预测ICU入院方面的表现也是可以接受的（AUC0.75；95％CI0.74，0.77），并且通过包括NLR（AUC0.76，95％CI0.74，0.77，p=0.008），虽然临床意义有限。在预测住院CAP患者的死亡率方面，NLR并不优于PSI。
