SynthesisThe Journal of infection2019
The utility of peripheral blood leucocyte ratios as biomarkers in infectious diseases: A systematic review and meta-analysis.
Synthesis in The Journal of infection, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05636202 (The Early Predictive Roles of NLR and NE% in In-hospital Mortality of Septic Patients), which is not on this map. Cited by 170 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Early Predictive Roles of NLR and NE% in In-hospital Mortality of Septic Patients: a Single-center 13-year Retrospective Study
Who cites it
170 citing papers in PubMed, 5 syntheses or guidelines pooled it, 291 citations in OpenAlex.
- Diagnostic accuracy of the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio in rheumatoid arthritis: a systematic review and meta-analysis.Clinical and experimental medicine · 2024Pooled it
- A systematic review and meta-analysis of the diagnostic accuracy of the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio in systemic lupus erythematosus.Clinical and experimental medicine · 2024Pooled it
- The Utility of Peripheral Blood Leucocyte Ratios as Biomarkers in Neonatal Sepsis: A Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2022Pooled it
- Prognostic value of neutrophil-to-lymphocyte ratio in COVID-19 patients: A systematic review and meta-analysis.International journal of clinical practice · 2021Pooled it
- Pooled it
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- Construction and validation of a machine learning model for predicting urine culture positivity in children with suspected urinary tract infections.Annals of medicine · 2026Article
- Early Clinical and Inflammatory Predictors of Supplemental Oxygen Requirement in Children Hospitalized with Acute Lower Respiratory Infection: A Multivariable Analysis.Microorganisms · 2026Article
- Association between 30-day mortality and serially measured hematologic markers in patients with septic shock in South Korea.Acute and critical care · 2026Article
- A drop of blood, a hint of risk: neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as early predictors and risk stratifiers in pyogenic spondylodiscitis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Utility of a Combined Diagnostic and Severity Scoring System Based on Complete Blood Count and Derived Immune-Inflammatory Indicators in Children With Mycoplasma pneumoniae Pneumonia.Journal of clinical laboratory analysis · 2026Article
- Association Between Neutrophil-to-Lymphocyte Ratio and Early Detection of Ventilator-Associated Pneumonia in Mechanically Ventilated ICU Patients.Journal of clinical medicine · 2026Article
- The neutrophil-to-lymphocyte ratio: a marker for microbial invasion of the amniotic cavity in preterm prelabor rupture of membranes.Obstetrics & gynecology science · 2026Article
- How reliable are ROC cut-offs? Evidence from simulation and empirical analysis.BMC medical research methodology · 2026Article
- Determinants of expert-advised antibiotic indication in pediatric emergency department, data from a cross-sectional prevalence survey.BMC pediatrics · 2026Article
- Diagnostic Value of Mean Platelet Volume and Hematological Inflammatory Ratios in Brucellosis: A Case-Control Study.Life (Basel, Switzerland) · 2026Article
- Evaluation of Neutrophil-to-Lymphocyte Ratio and CRP-to-Albumin Ratio in the Risk Stratification of Diabetic Foot Infection Severity.Medicina (Kaunas, Lithuania) · 2026Article
- Elevated neutrophil percentage-to-albumin ratio is associated with postoperative pneumonia in patients with hip fractures.Frontiers in medicine · 2026Article
- Prognostic Value of the Systemic Immuno-Inflammation Index (SII) in the Formation of Seroma and Hematoma Following Thyroidectomy.International archives of otorhinolaryngology · 2026Article
110 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 8 institutions in 4 countries.
Funding
Abstract
objectivesTo assess the utility of the neutrophil:lymphocyte (NLR), lymphocyte:monocyte (LMR) and platelet:lymphocyte ratios (PLR) as infection biomarkers.
methodsPubMed/MEDLINE, Embase and Cochrane databases were searched to identify eligible articles. Studies of diagnosis, severity or outcome were included. PROSPERO systematic review registration CRD42017075032.
resultsForty studies were included, reporting on bacterial and viral infections, malaria, and critical illness due to sepsis. Ten studies reported an association of higher NLR with bacteraemia, supported by meta-analysis of patient-level data (five studies, n = 3320; AUC 0.72, p<0.0001) identifying a cut-off of >12.65. Two studies reported an association with lower LMR and diagnosis of influenza virus infection in patients with respiratory tract infection. Meta-analysis of patient-level data (n = 85; AUC 0.66, p = 0.01) identified a cut-off of ≤2.06. The directionality of associations between NLR and outcomes in heterogeneous cohorts of critically ill adults with sepsis varied. Potential clinical utility was also demonstrated in pneumonia (NLR), pertussis (NLR), urinary tract infection (NLR), diabetic foot infections (NLR) and Crimean Congo Haemorrhagic Fever (PLR). Longitudinal measurement of LMR during respiratory virus infection reflected symptoms and NLR during sepsis and bacteraemia predicted mortality.
conclusionsPeripheral blood leucocyte ratios are useful infection biomarkers, with the most evidence related to diagnosis of bacteraemia and influenza virus infection. In critical illness due to sepsis, a signal towards an association with NLR and outcomes exists, and NLR should be evaluated in future stratification models. Longitudinal measurement of ratios during infection could be informative. Overall, these biomarkers warrant further recognition and study in infectious diseases.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.