Özet:

Purpose: In our study it is aimed to determine whether the neutrophil lymphocyte ratio is a useful parameter in the decision of treatment plan for patients who applied to emergency service with respiratory system complaints and who were diagnosed with pneumonia or lower respiratory tract infection by examining the relationship between the neutrophil lymphocyte ratio (NLR) and the emergency service outcome. Material and Method: Our study was performed retrospectively with 830 patients who were followed up in Saglik Bilimleri University Umraniye Training and Research Hospital Emergency Medicine Department due to pneumonia or lower respiratory tract infection and were consulted to Chest Diseases branch in terms of treatment plan between 01/01/2013 and 31/12/2015. Patients who were under 18 years old, patients with missing laboratory data and patients who were admitted to the service or intensive care unit due to additional comorbit conditions such as life-threatening acute coronary syndrome, cerebrovascular incident were excluded from the study. Patients' age, sex, laboratory results and emergency service outcomes were recorded. Findings: Of the 830 patients included in the study, 495 (59.64%) were male and 335 (40.36%) were female. The median age of the patients was determined as 74 (IQR: 64 – 82). 240 patients (28.92%) were discharged, 420 patients (50.60%) were hospitalized and 170 patients (20.48%) were admitted to intensive care unit. There was no significant difference in terms of emergency service outcome between males and females (p = 0.545). There was a significant difference between the groups in terms of median age (p = 0.004). Median NLR values were 6.30 (IQR: 3.87 – 10.16) in discharged patients, 6.64 (IQR: 4.02 – 11.99) in hospitalized patients and 10.17 (IQR 5.68 – 15.58) in intensive care unit patients. There was a significant difference between the groups in terms of median NLR values (p = 0.000). Significant differences were found between the groups in terms of leukocyte, neutrophil count, neutrophil percentage, lymphocyte count and lymphocyte percentage (p = 0.004, p <0.001, p <0.001, p <0.001, p = 0.011, p <0.001, p <0.001 respectively). When the patients were examined in two groups according to whether they were admitted to intensive care unit or not, a significant difference was found between the groups in terms of age, leukocyte count, neutrophil count, neutrophil percentage, lymphocyte count, lymphocyte percentage and neutrophil lymphocyte ratio (p = 0.006, p <0.001, p <0.001, p <0.001, p = 0.009, p <0.001, p <0.001, respectively). Conclusion: The increase in neutrophil lymphocyte ratio is related to the clinical severity of patients with pneumonia and lower respiratory tract infections and is a useful parameter that can be used in emergency medicine physicians in the treatment plan decision of patients.

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