Can “Rising Neutrophil Lymphocyte Ratio within the Normal Range of Total Leukocyte Count” be Considered as an Early and Economical Predictor of Sepsis in Critically Ill Trauma Patients?

INTRODUCTION: Sepsis is a life-threatening condition that is commonly observed in critically ill trauma patients, with early detection being essential for improved outcomes. While traditional markers such as white blood cell count (WBC), CRP, Lactate etc are used to detect infections, they often lack specificity. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a potential biomarker for various inflammatory conditions, including sepsis. However, its predictive value for sepsis in trauma patients, especially within the normal total leukocyte count (TLC) range, remains unclear. OBJECTIVE: This study aims to explore the role of an elevated neutrophil-to-lymphocyte ratio (NLR) within a normal TLC range as an early and cost-effective predictor of sepsis in critically ill trauma patients. METHODS: A retrospective analysis was conducted on critically ill trauma patients admitted to an intensive care unit (ICU) over a specified period. Data on TLC, NLR, and clinical outcomes were collected and analyzed. The NLR values were compared between sepsis and non-sepsis groups, and its diagnostic accuracy was assessed using receiver operating characteristic (ROC) curves.