Ventilator-associated pneumonia (VAP) is the most common nosocomial infection. Red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) are prognostic factors to mortality in different diseases. The aim of this study is to evaluate prognostic efficiency RDW, NLR, and the Sequential Organ Failure Assessment (SOFA) score for mortality prediction in respiratory patients with VAP. One hundred thirty-six patients mechanically ventilated and developed VAP were included. Clinical characteristics and SOFA score on the day of admission and at diagnosis of VAP, RDW, and NLR were assessed and correlated to mortality. The average age of patients was 58.80 ± 10.53. These variables had a good diagnostic performance for mortality prediction AUC 0.811 for SOFA at diagnosis of VAP, 0.777 for RDW, 0.728 for NLR, and 0.840 for combined of NLR and RDW. The combination of the three parameters demonstrated excellent diagnostic performance (AUC 0.889). A positive correlation was found between SOFA at diagnosis of VAP and RDW (r = 0.446, P < 0.000) and with NLR (r = 0.220, P < 0.010). NLR and RDW are non-specific inflammatory markers that could be calculated quickly and easily via routine hemogram examination. These markers have comparable prognostic accuracy to severity scores. Consequently, RDW and NLR are simple, yet promising markers for ICU physicians in monitoring the clinical course, assessment of organ dysfunction, and predicting mortality in mechanically ventilated patients. Therefore, this study recommends the use of blood biomarkers with the one of the simplest ICU score (SOFA score) in the rapid diagnosis of critical patients as a daily works in ICU.

中文翻译：

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预测呼吸机呼吸器相关性肺炎患者死亡率的预后生物标志物

呼吸机相关性肺炎（VAP）是最常见的医院感染。红细胞分布宽度（RDW）和中性白细胞-淋巴细胞比（NLR）是不同疾病死亡率的预后因素。这项研究的目的是评估RDW，NLR和序贯器官衰竭评估（SOFA）评分对VAP呼吸道疾病患者的死亡率预测的预后效率。包括136例机械通气并发展为VAP的患者。评估入院当天和诊断VAP，RDW和NLR时的临床特征和SOFA评分，并将其与死亡率相关联。患者的平均年龄为58.80±10.53。这些变量对于VFA诊断时SOFA的死亡率预测AUC 0.811，RDW 0.777，NLR 0.728和NLR和RDW组合0.840具有良好的诊断性能。这三个参数的组合显示出出色的诊断性能（AUC 0.889）。在诊断VAP和RDW时，SOFA与rLR呈正相关（r = 0.446，P <0.000），与NLR之间呈正相关（r = 0.220，P <0.010）。NLR和RDW是非特异性炎症标志物，可以通过常规血象检查快速，轻松地计算出。这些标志物的预后准确性与严重性评分相当。因此，RDW和NLR是ICU医师用于监测临床过程，评估器官​​功能障碍以及预测机械通气患者死亡率的简单但有希望的标志。因此，本研究建议在ICU的日常工作中，使用具有最简单ICU评分（SOFA评分）之一的血液生物标记物对重症患者进行快速诊断。