Research ArticleOriginal Article
Open Access

Neutrophil-to-lymphocyte ratio, platelets-to-lymphocyte ratio, and red cell distribution width as prognostic indicators for length of hospital stay in pediatric asthma

Ebtihal E. Eltyeb, Gassem A. Gohal, Sami A. Alhazmi, Mohammed A. Alqassim, Ehab F. Hakami, Mnar H. Moafa, Najla H. Mutahar, Maisaa M. Shanaq, Sara M. Shanaq, Abdullah J. Almalki, Asmaa A. Jabrah, Shorouq A. Mashhour, Ali A. Dagreri, Rahaf S. Othathi and Siddig Ibrahim Abdelwahab
Saudi Medical Journal February 2025, 46 (2) 143-149; DOI: https://doi.org/10.15537/smj.2025.46.2.20240934

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    - A receiver operating characteristic curve (ROC curve) to analyze the predictive value of each blood biomarker for length of hospital stay in asthma children. X-axis: 1-specifity, Y-axis: sensitivity, RDW: red cell distribution width, NLR: neutrophil-to-lymphocyte ratio, PLR: platelets-to-lymphocyte ratio

Tables

  • Table 1

    - The characteristics of the involved asthmatic children.

    Characteristicn(%)
    Gender
    Male292(59.7)
    Female197(40.3)
    Age (years)
    <12(0.4)
    1-5253(51.7)
    6-10175(35.8)
    11-1554(11.6)
    >151(0.2)
    Residence
    Jazan town44(9)
    Other town in Jazan Region65(13.3)
    Jazan rural area380(77.7)
    If patient has other type of allergy
    Yes23(4.7)
    No338(69.1)
    Not recorded128(26.2)
    Long term medications
    No medications339(69.3)
    Short acting beta agonist±inhaled corticosteroid (ICS)133(27.2)
    Leukotriene receptor antagonist±ICS3(0.6)
    Long acting beta agonist ±ICS12(2.5)
    Family history of bronchial asthma
    Yes142(29)
    No214(43.8)
    Not recorded133(27.2)
    Area of admission
    Regular ward443(90.6)
    Pediatrics intensive care unit40(8.2)
    Isolation6(1.2)
    Patient condition when admitted
    Stable254(51.9)
    Non-Stable32(6.5)
    Not recorded203(41.5)
    The need of resuscitation on admission
    Yes8(1.6)
    No287(58.7)
    Not recorded194(39.7)
    Provisional diagnosis
    Exacerbation of bronchial asthma alone365(74.6)
    Exacerbation of bronchial asthma with pneumonia24(4.9)
    Exacerbation of bronchial asthma with other cause100(20.4)
    If chest x-ray was doner
    Yes419(83.1)
    No84(16.9)
  • Table 2

    - Blood test that performed on admission for involved patients.

    VariablesMean±Standard deviation
    Hemoglobin11.82±4.85
    Total white blood cells11.41±5.38
    Neutrophil18.44±24.30
    Lymphocyte43.85±8.00
    Eosinophil0.79±1.86
    Red cell distribution width15.15±2.7
    Platelet371.44±116.17
    Neutrophil to lymphocyte ratio5.33±5.54
    Platelets to lymphocyte ratio184.84±167.15
  • Table 3

    - Cross tabulation for the distribution of patients across various PLR and NLR categories concerning different lengths of stay.

    VariablesLength of StayTotalP-value
    Short stay <24 hoursMedium stay: 1-3 daysLong stay: 4-7 daysVery long stay: > 7 days
    PLR
    Normal : <1206 (1.2%)144 (29.4%)66 (13.5%)13 (2.7%)229 (46.8%)9.779 (0.021)
    Abnormal : ≥ 1208 (1.6%)170 (34.8%)69 (14.1%)13 (2.7%)260 (53.2%) 
    NLR
    Normal : 1 - 36 (1.2%)144 (29.4%)66 (13.5%)13 (2.7%)229 (46.8%)0.542 (0.910)
    Abnormal: > 38 (1.6%)170 (34.8%)69 (14.1%)13 (2.7%)260 (53.2%) 

    p-value significant<0.05

    • Table 4

      - One-way ANOVA analysis to compare the RDW based on different lengths of stay.

      Length of stayNMean±SDF-statistics (p-value)
      Short stay:< 24 hours1215.1583± 2.298010.974 (0.405)
      Medium stay: 1-3 days24515.0706± 2.81536
      Long stay: 4-7 days10015.1311± 2.33441
      Very long stay: >7 days2016.1450± 3.22873

      P-value significant<0.05, RDW: Red cell distribution width, ANOVA: Analysis of variance

      • Table 5

        - Area under the curve (AUC) for diagnostic differentiation between RDW,NLR,PLR in relation to length of hospital stay.

        VariablesAreaStd. ErroraAsymptotic Sig.bAsymptotic 95% Confidence Interval
        Lower boundUpper bound
        RDW0.5550.0350.0870.4870.623
        NLR0.5530.0320.0990.4900.616
        PLR0.6640.0300.0000.6060.723

        RDW: red cell distribution width, NLR: neutrophil to lymphocyte ratio, PLR: platelets to lymphocyte ratio, Std: standard deviation,

        • ↵a Under the nonparametric assumption,

        • ↵b Null hypothesis: true area=0.5

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