Korelasi Positif antara Neutrophil Lymphocyte Count Ratio dan C-Reactive Protein pada Pasien Sepsis Anak

Adri Zamany Anwary, Dzulfikar Djalil Lukmanul Hakim, Djatnika Setiabudi

Sari


Latar belakang. Sepsis merupakan penyebab utama morbiditas dan mortalitas utama pada anak di seluruh dunia. C-reactive protein (CRP) merupakan penanda infeksi yang paling banyak digunakan, tetapi parameter tersebut terkendala tingkat sensitivitas, spesifisitas, ketersediaan alat, dan biaya. Neutrophil-lymphocyte Count Ratio (NLCR) merupakan pemeriksaan yang mudah dan murah, serta banyak digunakan sebagai penanda diagnostik pada berbagai proses inflamasi.
Tujuan. Menganalisis korelasi antara NLCR dan CRP pada pasien sepsis anak.
Metode. Studi analitik observasional menggunakan data sekunder dari register sepsis anak di RSUP Dr. Hasan Sadikin Bandung periode Januari 2019–Desember 2019. Pengambilan data berupa karakteristik pasien, nilai NLCR, dan CRP, didapatkan data tidak berdistribusi normal( uji Kolmogorov-Smirnov) maka analisis korelasi dilakukan menggunakan uji Rank Spearman dengan nilai kemaknaan p<0,05.
Hasil. Sebanyak 80 subjek memenuhi kriteria inklusi. Median nilai NLCR subjek 2,98 (rentang 0,12-19,38) dan nilai median CRP subjek 2,44 (rentang 0,01-34,04) Nilai NLCR memiliki korelasi bermakna dengan CRP (r=0,310; p=0,005).
Kesimpulan. Terdapat korelasi positif yang bermakna antara neutrophil-lymphocyte count ratio dengan CRP pada pasien sepsis anak.


Kata Kunci


Anak, Neutrophil-Lymphocyte Ratio, C Reactive Protein, Sepsis

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Referensi


Watson RS, Carcillo JA, Linde-zwirble WT, Clermont G, Lidicker J, Angus DC. The epidemiology of severe sepsis in children in the United States. Am J Respir Crit Care Med 2003;167:695-701.

Hartman ME, Linde-Zwirble WT, Angus DC, Watson RS. Trends in the epidemiology of pediatric severe sepsis. Pediatr Crit Care Med. 2013;14:686-93.

Souza DC De, Machado FR. Epidemiology of Pediatric Septic Shock. J Pediatr Intensive Care 2018;1-8.

Rudd KE, Johnson SC, Agesa KM dkk. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study. Lancet 2020;395:200-11.

Peryoga SU, Hudaya D, Alam A. The Correlation of Arterial Lactate Level and Base Excess with Disease Severity on PELOD-2 Score in Pediatric Sepsis. Pediatr Crit Care Med 2018;19:114.

Patel K, McElvania E. Diagnostic challenges and laboratory considerations for pediatric sepsis. J Appl Lab Med 2019;3:587-600.

Wulandari A, Martuti S, Kaswadi P. Perkembangan diagnosis sepsis pada anak. Sari Pediatri 2018;19:237-44.

Latief A, Chairulfatah A, Alam A, Pudjiadi A, Malisie RF, Hadinegoro SR. Pedoman nasional pelayanan kedokteran Ikatan Dokter Anak Indonesia: diagnosis dan tatalaksana sepsis pada anak. Jakarta: Badan penerbit IDAI; 2016.h.1-47.

De Jager CP, van Wijk PT, Mathoera RB, de Jongh-Leuvenink J, van der Poll T, Wever PC. Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit. Crit Care 2010;14:192.

Westerdijk K, Simons KS, Zegers M, Wever PC, Pickkers P, de Jager CP. The value of the neutrophil-lymphocyte count ratio in the diagnosis of sepsis in patients admitted to the Intensive Care Unit: A retrospective cohort study. PloS one 2019;14:1-13.

Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001;102:5-14.

De Pablo R, Monserrat J, Prieto A, Alvarez-Mon M. Role of circulating lymphocytes in patients with sepsis. Biomed Res Int 2014;671087:1-12.

Mandal RK, Valenzuela PB. Neutrophil-Lymphocyte count ratio on admission as a predictor of Bacteremia and In Hospital Mortality among Sepsis and Septic shock In Patients at Rizal Medical Center. Asian J Med Sci 2018;9:36-40.

Lefevre N, Noyon B, Biarent D, Corazza F, Duchateau J, Casimir G. Sex Differences in Inflammatory se and Acid-Base Balance in Prepubertal Children with Severe Sepsis. Shock 2017;47:422-8.

Fleischmann-struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. Review The global burden of paediatric and neonatal sepsis : a systematic review. Lancet Respir.. 2018;6:223-30.

Randolph AG, McCulloh RJ. Pediatric sepsis: Important considerations for diagnosing and managing severe infections in infants, children, and adolescents. Virulence 2014;5:172-82.

Weiss SL, Fitzgerald JC, Pappachan J, dkk. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med 2015;191:1147-57.

Tamelytė E, Vaičekauskienė G, Dagys A, Lapinskas T, Jankauskaitė L. Early blood biomarkers to improve sepsis/bacteremia diagnostics in pediatric emergency settings. Medicina 2019;55:1-13.

Saputra IM, Gustawan W, Utama MD, Arhana BN. Rasio Neutrofil dan Limfosit (NLCR) Sebagai Faktor Risiko Terjadinya Infeksi Bakteri di Ruang Rawat Anak RSUP Sanglah Denpasar. Sari Pediatri 2019;20:354-9.

Gozdas H, Gel K, Yasayacak A, Kesgin M, Akdeniz H. The role of hematological parameters in estimating nosocomial sepsis. Electron J Gen Med 2019;16:1-5.

Ghrahani R, Yuniati T, Judistiani RT, Setiabudiawan B. Strong Positive Correlation between Neutrophil-to-lymphocyte Ratio and C-reactive Protein in Early Onset Sepsis. Majalah Kedokt Bandung 2019;51:246-52.

Leteurtre S, Duhamel A, Salleron J, Grandbastien B, Lacroix J, Leclerc F, Groupe Francophone de Réanimation et d’Urgences Pédiatriques (GFRUP. PELOD-2: an update of the PEdiatric logistic organ dysfunction score. Crit Care Med J 2013;41:1761-73.

Schlapbach LJ, Straney L, Bellomo R, MacLaren G, Pilcher D. Prognostic accuracy of age-adapted SOFA, SIRS, PELOD-2, and qSOFA for in-hospital mortality among children with suspected infection admitted to the intensive care unit. Intensive Care Med 2018;44:179-88.

Mathews S, Rajan A, Soans ST. Prognostic value of rise in neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in predicting the mortality in paediatric intensive care. Int J Contemp Pediatr 2019;6:1052.

Faix JD. Biomarkers of sepsis. Crit Rev Clin Lab Sci 2013;50:23-36.




DOI: http://dx.doi.org/10.14238/sp23.1.2021.1-5

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