Lymphocyte-To-C-Reactive Protein Ratio As An Early Prognostic Marker In Emergency Department Patients With Sepsis: A Retrospective StuDY

Abstract

Background: Sepsis is a life-threatening condition associated with systemic inflammation, immune dysfunction and organ failure.
Early identification of patients at increased risk of mortality and acute kidney injury (AKI) remains challenging. The lymphocyte-to-Creactive
protein ratio (LCR) combines information on lymphocyte depletion and systemic inflammation and may have prognostic value.
Methods: A retrospective observational study was conducted among 400 adult patients with sepsis presenting to the emergency
department. Baseline demographic, clinical and laboratory data were collected. LCR was calculated from the initial absolute
lymphocyte count and CRP concentration. Patients were categorized into four LCR quartiles. The primary outcome was 30-day allcause
mortality, while AKI was evaluated as a secondary outcome. ROC analysis, Kaplan-Meier survival analysis and multivariable
regression were performed.
Results: Overall, 110 patients (27.5%) died within 30 days and 182 (45.5%) developed AKI. Mortality decreased progressively across
LCR quartiles, from 36.6% in Q1 to 16.2% in Q4 (p=0.003). AKI similarly decreased from 59.4% in Q1 to 31.3% in Q4 (p<0.001).
Lower LCR was associated with higher disease severity, inflammatory burden and organ dysfunction. LCR demonstrated an AUC of
0.671 for 30-day mortality and 0.648 for AKI. Kaplan-Meier analysis showed significantly poorer survival among patients with lower
LCR (log-rank p<0.001). Higher LCR remained associated with lower mortality and AKI after multivariable adjustment.
Conclusion: Lower LCR was associated with increased 30-day mortality and AKI in emergency department patients with sepsis.
LCR may serve as a simple adjunctive biomarker for early risk stratification.