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Diagnostic Value of the Neutrophil Lymphocyte Ratio in Discrimination Between Tuberculosis and Bacterial Community Acquired Pneumonia: A Meta-Analysis Publisher



Shojaan H1 ; Kalami N1 ; Ghasempour Alamdari M2 ; Emami Alorizy SM3 ; Ghaedi A3, 4 ; Bazrgar A3 ; Khanzadeh M5 ; Luckewold B6 ; Khanzadeh S6
Authors
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Authors Affiliations
  1. 1. Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  2. 2. Department of Pediatric Pulmonology, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  4. 4. Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
  5. 5. Geriatric & Gerontology Department, Medical School, Tehran University of Medical and Health Sciences, Tehran, Iran
  6. 6. Tabriz University of Medical Sciences, Tabriz, Iran

Source: Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Published:2023


Abstract

Background: We conducted a systematic review and meta-analysis, based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, to evaluate current literature on diagnostic value of neutrophil to lymphocyte ratio (NLR) in discrimination between tuberculosis (TB) and bacterial community acquired pneumonia (B-CAP). Methods: Literature search was conducted from July 20, 2023 using Scopus, PubMed, and Web of Science databases. STATA software (version 12.0; Stata Corporation) was used for all analyses. Results: We found that patients with TB had significantly lower levels of NLR compared to those with B-CAP (SMD = −1.09, 95 %CI = −1.78- −0.40, P = 0.002). In the quality subgroup analysis, we found that patients with TB had significantly lower level of NLR compared to those with B-CAP consistent in moderate (SMD = -0.86, 95 %CI = −2.30, 0.57, P = 0.23) and high-quality studies (SMD = -1.25, 95 %CI = -2.07, −0.42). In the subgroup analysis based on continent, we found that patients with TB had significantly lower level of NLR compared to those with B-CAP in studies performed in Asian populations (SMD = -1.37, 95 %CI = −2.13, −0.61, P < 0.001), but not on African population (SMD = -0.02, 95 %CI = −1.06, 1.02, P = 0.97). The result of this study did not change after execution of sensitivity analysis. The pooled sensitivity of NLR was 0.86 (95% CI = 0.80, 0.91), and the pooled specificity was0.88 (95% CI = 0.69, 0.95). Conclusion: Patients with TB had a significantly lower NLR levels compared to those with B-CAP, so we utilized this biomarker for distinguishing between the disorders. © 2023 The Authors
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