Abstract:

Objective: To evaluate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) and serum procalcitonin (PCT) in ICU patients with severe pulmonary tuberculosis. Methods: All of 144 patients with severe pulmonary tuberculosis admitted to the ICU of Hebei Chest Hospital from January 2021 to December 2023 were retrospectively analyzed. Patients were divided into a survival group (n=67) and a death group (n=77) according to their survival status after 28 days in ICU. Basic clinical data. the results of NLR, serum PCT and other laboratory tests results within 24 hours of ICU admission were collected. The predictive efficacy of these indicators individually and in combination for prognosis of ICU patients with severe tuberculosis were compared between groups. Results: The levels of NLR and serum PCT in the death group were higher than those in the survival group (NLR: 12.76 (9.49, 23.44) vs 8.13 (6.24, 15.06)), PCT: 4.18 (2.64, 5.66) ng/ml vs 2.31 (1.09, 3.52) ng/ml), and the difference was statistically significant (Z=-5.501、-5.343, both P<0.001). For individual prognostic prediction in ICU patients with severe pulmonary tuberculosis, the area under the receiver operating characteristic curve (AUC) of NLR was 0.766, with a sensitivity of 75.3% and specificity of 70.1%. The AUC for PCT was 0.759, with a sensitivity of 77.9% and specificity of 65.7%. The AUC of the combination of the two indicators was 0.833, with a sensitivity of 81.8% and specificity of 73.1%. Conclusion: Compared to a individual test, the combined NLR and serum PCT detection demonstrates higher prognostic value for ICU patients with severe pulmonary tuberculosis, providing valuable insights for clinical diagnosis and treatment.

Key words: Critical illness, Tuberculosis, pulmonary, Neutropenia, Lymphocytes, Prognosis