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Agreement between neutrophil/lymphocyte ratio and procalcitonin for determining severe community acquired pneumonia in children

Authors:

I Gusti Ayu Dwi Aryani ,

Medical School of Udayana University, Sanglah Hospital, Denpasar, Bali, ID
About I Gusti
Department of Paediatrics
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Ayu Setyorini Mestika Mayangsari,

Medical School of Udayana University, Sanglah Hospital, Denpasar, Bali, ID
About Ayu
Department of Paediatrics
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Eka Gunawijaya,

Medical School of Udayana University, Sanglah Hospital, Denpasar, Bali, ID
About Eka
Department of Paediatrics
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Made Kardana,

Medical School of Udayana University, Sanglah Hospital, Denpasar, Bali, ID
About Made
Department of Paediatrics
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I Gusti Ngurah Sanjaya Putra,

Medical School of Udayana University, Sanglah Hospital, Denpasar, Bali, ID
About I Gusti
Department of Paediatrics
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I Nyoman Budi Hartawan,

Medical School of Udayana University, Sanglah Hospital, Denpasar, Bali, ID
About I Nyoman
Department of Paediatrics
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Anak Agung Ngurah Ketut Putra Widnyana

Medical School of Udayana University, Sanglah Hospital, Denpasar, Bali, ID
About Anak
Department of Paediatrics
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Abstract

Introduction: The use of inflammatory markers, such as procalcitonin, in assessing the severity of community acquired pneumonia (CAP) is limited by its relatively high cost. Currently, the Neutrophil/Lymphocyte ratio (NLR) is considered to have an important role in the inflammatory process.


Objectives: To evaluated the agreement between NLR and procalcitonin for determining severe CAP in children.


Method: This was a cross-sectional study carried out in children aged 2 months to 18 years with CAP in the paediatric unit at Sanglah Hospital, Denpasar, Bali, Indonesia from August 2019 – March 2021. Statistical analysis was performed using ROC to find the cut-off point of NLR. Analysis was performed to determining severe CAP based on cut-off points of procalcitonin and NLR. Cohen’s Kappa analysis between NLR and procalcitonin was performed for determining severe CAP with significant p-value <0.05.


Results: There were 58 subjects analysed in this study. Analysis performed by ROC showed cut off point of NLR was 2.11 with sensitivity of 82.4% and specificity of 83.3% while procalcitonin had a cut-off point of 1 ng/ml with a sensitivity 85.3% and specificity 87.5% to predict severe CAP. The agreement analysis between NLR with cut-off point 2.11 and procalcitonin with cut-off point 1 ng/ml showed substantial agreement for determining severe CAP in children (k=0,62; p=0,001).


Conclusions: There was substantial agreement between NLR and procalcitonin for determining severe CAP in children.


Sri Lanka Journal of Child Health, 2022; 51(4): 547-552

How to Cite: Aryani, I.G.A.D., Mayangsari, A.S.M., Gunawijaya, E., Kardana, M., Putra, I.G.N.S., Hartawan, I.N.B. and Widnyana, A.A.N.K.P., 2022. Agreement between neutrophil/lymphocyte ratio and procalcitonin for determining severe community acquired pneumonia in children. Sri Lanka Journal of Child Health, 51(4), pp.547–552. DOI: http://doi.org/10.4038/sljch.v51i4.10368
Published on 05 Dec 2022.
Peer Reviewed

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