ArticleBMC geriatrics2025
The improved prediction value of neutrophil to lymphocyte ratio to pneumonia severity scores for mortality in the older people with community-acquired pneumonia.
Article in BMC geriatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- The neutrophil-to-lymphocyte ratio as a marker of immunosenescence and COVID-19 outcomes in the elderly: A narrative review.Physiological reports · 2026Review
- Improved prediction value of the CURB-65 score combined with the platelet-to-lymphocyte ratio for mortality in emergency department patients with severe community-acquired pneumonia.Frontiers in medicine · 2026Article
- Diagnostic efficacy of monocyte distribution width to high-sensitivity C-reactive protein ratio in differentiating pathogen types in community-acquired pneumonia: a retrospective cohort study.Open medicine (Warsaw, Poland) · 2026Article
- Complete blood counts and their derived inflammatory markers with anal fistulas in male children: A retrospective case-control study.World journal of gastroenterology · 2025Article
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9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe aimed to evaluate whether there is a linear relationship between neutrophil to lymphocyte ratio (NLR) and adverse outcomes in the older hospitalised patients with community-acquired pneumonia (CAP). The performance of adding NLR to current pneumonia severity scores, including CURB-65, CRB-65, A-DROP and SMART-COP, in predicting 30-day mortality was also investigated.
methodsThis is a secondary analysis based on an existing dataset of an older cohort of CAP, including 812 patients. Clinical and laboratory results on admission were used to calculate the above scores. The primary outcome was 30-day mortality. Baseline characteristics and outcomes were presented grouped by quartile of NLR. Multivariable adjusted logistic regression and restricted cubic spline were used to evaluate the association between NLR and 30-day mortality. Updated systems were developed after adding NLR to the above four scoring systems. Model discrimination was evaluated by the area under receiver operating characteristic curve (AUCs).
resultsCompared with the lowest quartile NLR group, the higher quartile NLR group had an increased risk of 30-day mortality, with a rate of 18.3% (37/202) in the highest quartile. A significant association of NLR with 30-day mortality was found with an odds ratio of 1.017 (95% confidence interval [CI] 1.002-1.032]), but did not persist after adjustment for age, sex, and comorbidities. A non-linear positive association was observed for NLR with 30-day mortality, with an accelerating mortality rate up to 16 of NLR. The optimal cut-off value of NLR for predicting 30-day mortality was 6.5, which was used to update the scoring systems by adding NLR. The AUCs after updating in the four systems were all significantly improved (all p < 0.05), with the highest AUC of 0.847 (95%CI 0.804-0.891) in SMARTCOP-NLR and the lowest AUC of 0.804 (95% CI 0.752-0.855) in CRB65-NLR.
conclusionsThere was a non-linear association between NLR and 30-day mortality in older patients with CAP. The addition of NLR to the conventional scoring systems significantly increased their discrimination.
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