Korelasi Rasio Monosit-High Density Lipoprotein, Rasio Neutrofil–Limfosit Dihubungkan dengan Skor Sofa pada Pasien Sepsis

Abstract

Background : Sepsis is life-threatening organ dysfunction caused a dysregulated host response to infection. Organ dysfunction was identified in sequential organ failure assessment (SOFA) score ≥2. One of the body's physiological responses to fight inflammation is to increase neutrophil and decrease lymphocyte levels. This is due to changes in regulation of apoptosis events during systemic inflammation where neutrophil apoptosis is inhibited and lymphocyte apoptosis is accelerated, causing an increase in the level of neutrophil-lymphocyte ratio (RNL). The innate immune system response also increases monocytes which will interact with bacterial endotoxins. HDL inhibits monocyte activity and blocks transformation of monocytes into macrophages. HDL plays important role in binding and neutralizing endotoxins. High monocyte-high density lipoprotein ratio (RMH) indicates poor prognosis in sepsis. Objective : To determine correlation of monocyte-high density lipoprotein ratio and neutrophil-lymphocyte ratio related to SOFA score in sepsis patients. Methods : Analytical research with cross sectional design on 47 sepsis patients in the ICU at H. Adam Malik Hospital in Medan from February 2023 - May 2023 who met inclusion and exclusion criteria. Blood samples were taken for complete blood count and HDL level examination upon initial admission. Results : Of the 47 patients, there were 27 male (57.4 % ) and 20 (42.6%) female. Median age was 57 years with the youngest 25 years old and the oldest 93 years old. The median RMH value was 0.04 ( 0.00 - 0.61). The median RNL value was 13.38 ( 1.47 – 187.56) and the mean SOFA score was 9.94. Using the Spearman correlation test, insignificant correlation was found between RMH and SOFA score (p=0.263), and insignificant correlation between RNL and SOFA score (p=0.269). Conclusion : There is no correlation between monocyte-high density lipoprotein ratio and neutrophil-lymphocyte ratio with SOFA score