CORRELATION OF NEUTROPHIL LYMPHOCYTE RATIO (NLR) VALUES WITH C-REACTIVE PROTEIN (CRP) LEVELS IN PNEUMONIA PATIENTS
Abstrak
Pneumonia is an acute infection of the lungs caused by microorganisms such as bacteria, viruses, or fungi, which trigger inflammation and weaken the immune system. Early detection is crucial for guiding treatment strategies and reducing the risk of complications. One indicator that can be used for the systemic inflammatory response due to pneumonia infection is the Neutrophil Lymphocyte Ratio (NLR). In addition to NLR, C-Reactive Protein (CRP) levels can also be examined to determine the level of infectious disease activity. This study aimed to assess the correlation between NLR values and CRP levels in pneumonia patients. This is a descriptive correlational study with a cross-sectional design that was conducted on 25 adult and elderly pneumonia patients with comorbidities, selected through consecutive sampling. This research was conducted at Dr. H. A. Rotinsulu Lung Hospital, with the research time being November 6 –18, 2024. The mean neutrophil percentage was 76.9%, lymphocytes 13.4%, NLR 9.12, and CRP level 83 mg/L. Spearman’s correlation test showed a significant positive correlation between NLR and CRP (r=0.415, p=0.039). These results indicate that higher NLR values are associated with increased CRP levels in pneumonia patients.
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Referensi
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20. Sari AP, Ratnawati R, Aniwidyaningsih W, Andarini SL, Yunus F. Neutrophyl – Lymphocyte Ratio (NLR) and C-Reactive Protein (CRP) Levels in Stable and Exacerbated Chronic Obstructive Pulmonary Disease (COPD) Patients in Persahabatan Hospital Jakarta. Respir Sci. 2022;2(2):78-91. doi:10.36497/respirsci.v2i2.38
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24. Hsu CW, Suk CW, Hsu YP, et al. Sphingosine-1-phosphate and CRP as potential combination biomarkers in discrimination of COPD with community-acquired pneumonia and acute exacerbation of COPD. Respir Res. 2022;23(1):1-7. doi:10.1186/s12931-022-01991-1
25. Kan T, Komiya K, Honjo K, et al. Impact of additional antibiotics on in-hospital mortality in tuberculosis isolated general bacteria: A propensity score analysis. J Infect Chemother. 2019;25(9):714-719. doi:10.1016/j.jiac.2019.03.022
26. Huang D, He D, Gong L, et al. Clinical characteristics and risk factors associated with mortality in patients with severe community-acquired pneumonia and type 2 diabetes mellitus. Crit Care. 2021;25(1):1-14. doi:10.1186/s13054-021-03841-w
27. L. Ferreira, A.C. Moniz, A.S. Carneiro, A.S. Miranda, C. Fangueiro, D. Fernandes I, Silva, I. Palhinhas, J. Lemos, J. Antunes, M. Leal, N. Sampaio SF. The impact of glycemic variability on length of stay and mortality in diabetic patients admitted with community-acquired pneumonia or chronic obstructive pulmonary disease. Diabetes Metab Syndr Clin Res Rev. 2019;13(1):149-153.
28. Chen B, Liu W, Chen Y, et al. Effect of Poor Nutritional Status and Comorbidities on the Occurrence and Outcome of Pneumonia in Elderly Adults. Front Med. 2021;8(October). doi:10.3389/fmed.2021.719530
29. Regalado NG, Martin G, Antony SJ. Acinetobacter lwoffii: Bacteremia associated with acute gastroenteritis. Travel Med Infect Dis. 2009;7(5):316-317. doi:10.1016/j.tmaid.2009.06.001
2. Widodo RD, Isnani N. Overview Of Potential Corticosteroid Drug Interactions In Childhood Pneumonia Patients In The Inpatient Installation Of Ulin Hospital Banjarmasin. J Kaji Ilm Kesehat dan Teknol. 2023;5(2):131-137.
3. Siti Khodijah, Wirda Syari, Fenny Raharyanti. Analisis Implementasi Penemuan Dan Tatalaksana Pneumonia. Promot J Mhs Kesehat Masy. 2022;5(5):75-93.
4. Htun TP, Sun Y, Chua HL, Pang J. Clinical features for diagnosis of pneumonia among adults in primary care setting: A systematic and meta-review. Sci Rep. 2019;9(1):1-10. doi:10.1038/s41598-019-44145-y
5. Kementerian Kesehatan RI. Laporan Nasional: Riset Kesehatan Dasar (Riskesdas) 2023. Jakarta :Kementerian Kesehatan; 2023.
6. Wasita IKS, Setiawan PA, Suryawan IWB, Widiasa AAM. Perbedaan rasio neutrofil-limfosit terhadap lama rawat anak dengan pneumonia di Ruang Kaswari, RSUD Wangaya, Denpasar, Bali, Indonesia. Intisari Sains Medis. 2019;10(3):851-857. doi:10.15562/ism.v10i3.471
7. Sudiartha IPG, Wiargitha IK, Mahadewa TGB. Perbedaan nilai Neutrophil Lymphocyte Ratio (NLR) terhadap pemeriksaan kultur darah dalam mendiagnosis sepsis pada pasien peritonitis di RSUP Sanglah, Bali, Indonesia. Intisari Sains Medis. 2020;11(1):165-171. doi:10.15562/ism.v11i1.571
8. Lee H, Kim I, Kang BH, Um SJ. Prognostic value of serial neutrophil-to-lymphocyte ratio measurements in hospitalized community-acquired pneumonia. PLoS One. 2021;16(4 April):1-12. doi:10.1371/journal.pone.0250067
9. Huang Y, Liu A, Liang L, et al. Diagnostic value of blood parameters for community-acquired pneumonia. Int Immunopharmacol. 2018;64(August):10-15. doi:10.1016/j.intimp.2018.08.022
10. Renowati R, Sefridana R. Korelasi C-Reactive Protein Dengan Trombosit Pada Penderita Demam Berdarah Dengue. Pros Semin Kesehat Perintis. 2020;3(1):8-11.
11. Cahyani S, Rizkianti T, Susantiningsih T. Hubungan Jumlah Trombosit , Nilai Hematokrit dan Rasio Neutrofil-Limfosit Terhadap Lama Rawat Inap Pasien DBD Anak di RSUD Budhi Asih Bulan Januari – September Tahun2019. Semin Nas Ris Kedokt 2020. 2020;1(1):49-59.
12. Idhayu AT, Chen LK, Suhendro S, Abdullah M. Perbedaan Kadar C-Reactive Protein pada Demam Akut karena Infeksi Dengue dan Demam Tifoid. J Penyakit Dalam Indones. 2016;3(3):138. doi:10.7454/jpdi.v3i3.24
13. Ekawati D, Wijayanti DR, Ritonga AFR. Hubungan Nlr Dengan Kadar Hs-Crp Pada Kasus Demam Dengueperiode Tahun 2019-2021 Di Prodia Depok. Binawan Student J. 2022;4(3):37-43. doi:10.54771/bsj.v4i3.677
14. Nuraeni M, Wardani LSC, Dewi MC, Srimiyati. Hubungan Kadar C-Reaktiv Protein (CRP) degan Nilai Cycle Treshold (CT) pada Penderita Covid-19. Syntax Lit J Ilm Indones. 2022;7(8):10699-10707.
15. Fristiani R, Warida W, Edward H. Hubungan Nilai Neutrophil-Lymphocyte Ratio (NLR) Dan Kadar C-Reactive Protein (CRP) Dengan Tingkat Keparahan Penyakit Pada Pasien Covid-19. Ahmar Metastasis Heal J. 2022;2(2):68-74. doi:10.53770/amhj.v2i2.121
16. Abdjul RL, Herlina S. Asuhan Keperawatan Pada Pasien Dewasa Dengan Pneumonia : Study Kasus. Indones J Heal Dev. 2020;2(2):102-107.
17. Farida Y, Putri VW, Hanafi M, Herdianti NS. Profil Pasien dan Penggunaan Antibiotik pada Kasus Community-Acquired Pneumonia Rawat Inap di Rumah Sakit Akademik wilayah Sukoharjo. JPSCR J Pharm Sci Clin Res. 2020;5(2):151. doi:10.20961/jpscr.v5i2.39763
18. Falagas ME, Mourtzoukou EG, Vardakas KZ. Sex differences in the incidence and severity of respiratory tract infections. Respir Med. 2007;101(9):1845-1863. doi:10.1016/j.rmed.2007.04.011
19. Cataudella E, Giraffa CM, Di Marca S, et al. Neutrophil-To-Lymphocyte Ratio: An Emerging Marker Predicting Prognosis in Elderly Adults with Community-Acquired Pneumonia. J Am Geriatr Soc. 2017;65(8):1796-1801. doi:10.1111/jgs.14894
20. Sari AP, Ratnawati R, Aniwidyaningsih W, Andarini SL, Yunus F. Neutrophyl – Lymphocyte Ratio (NLR) and C-Reactive Protein (CRP) Levels in Stable and Exacerbated Chronic Obstructive Pulmonary Disease (COPD) Patients in Persahabatan Hospital Jakarta. Respir Sci. 2022;2(2):78-91. doi:10.36497/respirsci.v2i2.38
21. Aufani D, Azzahra L, Supriyanto S, Fatayati I, Nuswantoro A. Korelasi Antara Rasio Neutrofil/Limfosit Dengan Kadar C-Reactive Protein Pada Penderita Tuberkulosis Paru. Media Penelit dan Pengemb Kesehat. 2023;33(2):114-120. doi:10.34011/jmp2k.v33i2.2089
22. Wardah, W., Nurjannah, N., Bakhtiar, B., & Daulay RS. Penanda Infeksi Bakteri pada Pneumonia Anak. Maj Kedokt Nusant J Med Sch USU. 2013;46(2):107-111.
23. Arlini, Yunita. Diagnosis Community Aquired Pneumonia (CAP) dan Tatalaksana Terkini. Bagian Pulmunologi dan Kedokt Respirasi Fak Kedokt Univ Syiah Kuala. Published online 2015:86-97.
24. Hsu CW, Suk CW, Hsu YP, et al. Sphingosine-1-phosphate and CRP as potential combination biomarkers in discrimination of COPD with community-acquired pneumonia and acute exacerbation of COPD. Respir Res. 2022;23(1):1-7. doi:10.1186/s12931-022-01991-1
25. Kan T, Komiya K, Honjo K, et al. Impact of additional antibiotics on in-hospital mortality in tuberculosis isolated general bacteria: A propensity score analysis. J Infect Chemother. 2019;25(9):714-719. doi:10.1016/j.jiac.2019.03.022
26. Huang D, He D, Gong L, et al. Clinical characteristics and risk factors associated with mortality in patients with severe community-acquired pneumonia and type 2 diabetes mellitus. Crit Care. 2021;25(1):1-14. doi:10.1186/s13054-021-03841-w
27. L. Ferreira, A.C. Moniz, A.S. Carneiro, A.S. Miranda, C. Fangueiro, D. Fernandes I, Silva, I. Palhinhas, J. Lemos, J. Antunes, M. Leal, N. Sampaio SF. The impact of glycemic variability on length of stay and mortality in diabetic patients admitted with community-acquired pneumonia or chronic obstructive pulmonary disease. Diabetes Metab Syndr Clin Res Rev. 2019;13(1):149-153.
28. Chen B, Liu W, Chen Y, et al. Effect of Poor Nutritional Status and Comorbidities on the Occurrence and Outcome of Pneumonia in Elderly Adults. Front Med. 2021;8(October). doi:10.3389/fmed.2021.719530
29. Regalado NG, Martin G, Antony SJ. Acinetobacter lwoffii: Bacteremia associated with acute gastroenteritis. Travel Med Infect Dis. 2009;7(5):316-317. doi:10.1016/j.tmaid.2009.06.001
Penulis
Maryani, N., Nurhayati, B., Dermawan, A., Abror, Y. K., & Thayyiba, A. (2025). CORRELATION OF NEUTROPHIL LYMPHOCYTE RATIO (NLR) VALUES WITH C-REACTIVE PROTEIN (CRP) LEVELS IN PNEUMONIA PATIENTS. JURNAL RISET KESEHATAN POLTEKKES DEPKES BANDUNG, Online ISSN 2579-8103, 17(2), 556–564. https://doi.org/10.34011/juriskesbdg.v17i2.2831
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