,
Department of Pulmonology, General Hospital “Prim. dr. Abdulah Nakaš“ , Sarajevo , Bosnia and Herzegovina
Department of Pathophysiology, School of Medicine, Sarajevo School of Science and Technology , Sarajevo , Bosnia and Herzegovina
Clinic for Pulmonary Diseases and Tuberculosis “Podhrastovi”, University Clinical Centre , Sarajevo , Bosnia and Herzegovina
Department of Physiology, School of Medicine, University of Sarajevo , Sarajevo , Bosnia and Herzegovina
Department of Pathophysiology, School of Medicine, University of Sarajevo , Sarajevo , Bosnia and Herzegovina
Primary Healthcare Centre Gračanica , Gračanica , Bosnia and Herzegovina
Department of Pathophysiology, School of Medicine, Sarajevo School of Science and Technology , Sarajevo , Bosnia and Herzegovina
Department of Pulmonology, General Hospital Tešanj , Tešanj , Bosnia and Herzegovina
Department of Pharmacology, Toxicology and Clinical Pharmacology, School of Medicine, Sarajevo School of Science and Technology , Sarajevo , Bosnia and Herzegovina
Department of Radiology, General Hospital “Prim. dr. Abdulah Nakaš“ , Sarajevo , Bosnia and Herzegovina
Aim
To investigate influence of neutrophil-to-lymphocyte ratio (NLR) and proatherogenic risk factors to improve the accuracy
of pneumonia severity index (PSI) in the prediction of community acquired pneumonia (CAP) outcome in healthy individuals.
Methods
A retrospective observational cross-sectional study conducted at the Clinic for Pulmonary Diseases and Tuberculosis “Podhrastovi”, University Clinical Centre Sarajevo, included 83 patients with the diagnosis of CAP during the period March
2019-March 2021. Once diagnosed with CAP, PSI score was calculated and according to its value the need for hospital treatment was identified. Patients were divided in two groups: low risk of CAP (PSI <90), and high risk of CAP (PSI> 90).
Results
The overall average hospital stay was 22.76±10.154 days. In the patients diagnosed with CAP, a positive correlation was
established between the following parameters PSI score and age (r=0.670; p<0.01), C-reactive protein-CRP (rho=0.287; p<0.01), leukocytes (rho=0.406; p<0.01), NLR (rho=0.313; p<0.01) and platelet to lymphocyte ratio (PLR) (0.296; p<0.05). CRP, leukocytes, NLR and PLR were statistically significantly higher in patients with high risk of CAP compared to patients with low risk of CAP. Diastolic blood pressure, lymphocytes, eosinophils were significantly lower in patients with high risk of CAP (p<0.05;) compared to patients with low risk of CAP (p<0.01). The optimal cut-off value of NLR for CAP patients was 3.089 with an estimated area under curve (AUC) of 0.664.
Conclusion
Proatherogenic parameters such as age, systolic blood pressure and leukocytes in combination with neutrophil-lymphocyte count ratio could improve accuracy of the pneumonia severity index in community acquired pneumonia outcome.
This work is licensed under a Attribution-NonCommercial-NoDerivatives 4.0 International 
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