International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Neutrophil-to-lymphocyte ratio combined with CURB-65 score to identify patients at high risk of 30-day mortality in community-acquired pneumonia through the emergency medical department of tertiary hospitals.
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Schroeder Chaidron Léna, Creutz Emilie, Cremer Kelly, Penaloza-Baeza Andrea, Robert Annie, Yombi Jean Cyr
Аннотация
OBJECTIVES: This study aimed to assess the additive value of the neutrophil-to-lymphocyte ratio (NLR) to the CURB-65 score for improving identification of elderly patients with community-acquired pneumonia (CAP) at high risk of mortality in the emergency medical department (EMD).
METHODS: This retrospective study included consecutive patients with CAP admitted to the EMD of a Belgian tertiary hospital between 2020 and 2022. Patients were divided into three age subgroups: <65 years, 65-79 years and ≥80 years. Clinical and laboratory data were collected from medical records. Hierarchical models of CURB-65 with and without NLR were compared using multivariate logistic regression to assess the added predictive value of NLR on 30-day mortality.
RESULTS: Eight hundred and sixty nine patients were included. 30-day mortality increased with age (<65 years: 2.0%; 65-79 years: 8.8%; ≥80 years: 19.7%). NLR ≥16 was associated with 30-day mortality and adding NLR to the CURB-65 score improved 30-day mortality prediction compared to the CURB-65 alone in both 65-79 years and ≥80 years subgroups.
CONCLUSIONS: NLR ≥16 has an additional prognostic value to the CURB-65 score in EMD patients with CAP aged ≥65 years. The CURB-65-NLR≥16 score may improve mortality risk stratification among elderly patients by classifying them into intermediate, high and very-high risk categories.
METHODS: This retrospective study included consecutive patients with CAP admitted to the EMD of a Belgian tertiary hospital between 2020 and 2022. Patients were divided into three age subgroups: <65 years, 65-79 years and ≥80 years. Clinical and laboratory data were collected from medical records. Hierarchical models of CURB-65 with and without NLR were compared using multivariate logistic regression to assess the added predictive value of NLR on 30-day mortality.
RESULTS: Eight hundred and sixty nine patients were included. 30-day mortality increased with age (<65 years: 2.0%; 65-79 years: 8.8%; ≥80 years: 19.7%). NLR ≥16 was associated with 30-day mortality and adding NLR to the CURB-65 score improved 30-day mortality prediction compared to the CURB-65 alone in both 65-79 years and ≥80 years subgroups.
CONCLUSIONS: NLR ≥16 has an additional prognostic value to the CURB-65 score in EMD patients with CAP aged ≥65 years. The CURB-65-NLR≥16 score may improve mortality risk stratification among elderly patients by classifying them into intermediate, high and very-high risk categories.