Research Article

The sensitivity and specificity of neutrophil lymphocyte count ratio in diagnosing sepsis patients at Dr. Saiful Anwar General Hospital, Malang, Indonesia

Agustin Iskandar, Yeni Ayu Prihastuti , Muhammad Anshory

Agustin Iskandar
Departemen Patologi Klinik Fakultas Kedokteran Universitas Brawijaya Malang

Yeni Ayu Prihastuti
PPDS Patologi Klinik Fakultas Kedokteran Universitas Brawijaya Malang/RSUD dr. Saiful Anwar, Malang. Email:

Muhammad Anshory
Departemen Ilmu Penyakit Dalam Rumah Sakit Umum Saiful Anwar Malang
Online First: March 25, 2019 | Cite this Article
Iskandar, A., Prihastuti, Y., Anshory, M. 2019. The sensitivity and specificity of neutrophil lymphocyte count ratio in diagnosing sepsis patients at Dr. Saiful Anwar General Hospital, Malang, Indonesia. Intisari Sains Medis 10(1). DOI:10.15562/ism.v10i1.338

Background: Sepsis is the most severe manifestation of acute infection which can cause death in 30-50% of cases. Rapid and accurate diagnosis of sepsis is a challenge for clinicians and laboratories. Neutrophil Lymphocyte Count Ratio is a potential index to detect the occurrence of sepsis. This examination is easy, fast and cheap. Procalcitonin is currently widely used as a newer indicator in diagnosing pre-shock but is rarely done because of its cost. This study aims to compare the diagnostic value of Neutrophil Lymphocyte Count Ratio with procalcitonin as a marker in septic

Method: A Case-control analytic research was conducted from March to June 2018. Examination of neutrophils and lymphocytes using Sysmex XN-1000 while procalcitonin examination used Elecsys BRAHMS PCT using ECLIA method. Diagnostic values are analyzed using the ROC curve, and the cut-off value is determined. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy are calculated with 2x2 tables.

Result: The subjects of the study were 60 patients who hospitalized and examined for procalcitonin with 30 patients diagnosed based on clinical symptoms and SOFA score ≥ two by clinicians as sepsis patients and also 30 control patients. ROC analysis with procalcitonin cut-off values of 2,24 ng / mL obtained a sensitivity of 93%, specificity of 86,7%, PPV of 86,9%, and NPV of 92,4%.. At the cut-off value of Neutrophil Lymphocyte Count Ratio 5,06, there was a sensitivity of 80%, specificity of 76,7%, PPV of 76,9%, and NPV of 79,1%.

Conclusion: Procalcitonin has a better diagnostic value than Neutrophil Lymphocyte Count Ratio in diagnosing sepsis.


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