Perbedaan nilai Neutrophil Lymphocyte Ratio (NLR) terhadap pemeriksaan kultur darah dalam mendiagnosis sepsis pada pasien peritonitis di RSUP Sanglah, Bali, Indonesia

Background: Sepsis is a leading cause of death worldwide. A delayed or missed diagnosis of sepsis could increase its morbidity and mortality. The abdomen is the most common source of sepsis, which known as peritonitis-induced-sepsis. Peritonitis leads to an inflammatory and anti-inflammatory response. This study aims to elaborate on the role of Neutrophil Lymphocyte Ratio (NLR) as an easy, fast and inexpensive infection marker compared to blood culture, which known as the gold standard of sepsis in peritonitis patients. Methods: This is a diagnostic study which combined secondary data taken at Sanglah Hospital Medical Record Department and new cases of generalized peritonitis patients with sepsis who came to Surgical Emergency Unit of Sanglah Hospital as the subjects. A total of 86 subjects, complete blood count analysis was done to calculate NLR. Besides, 2-sided blood culture was tested to see whether the results were positive or negative. Data were analyzed using Stata/SE version 12.1 Results: We found that sensitivity of NLR compared to blood culture was 80% (CI:63.1-91.6), with specificity of 88.2% (CI:76.1-95.6), positive predictive value of 82.4% (CI:65.5-93.2), negative predictive value of 86.5% (74.2-94.4), accuracy of 84.9% and likelihood ratio (LR) positive value of 6.8>1. Our results showed that NLR has an enormous value in predicting the occurrence of sepsis in patients with generalized peritonitis. Conclusion: NLR can be used as a screening tool for sepsis in generalized peritonitis patients because it has better sensitivity and accuracy, but it has to confirmed by blood culture as the gold standard.