ABSTRACT

Objective

This study aimed to investigate the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) in predicting intensive care unit (ICU) requirements in pediatric community-acquired pneumonia (CAP).

Methods

In this retrospective study, demographic data, clinical findings, and laboratory results of pediatric patients diagnosed with CAP were evaluated. Patients were divided into two groups: those treated in the pediatric ward (Group 1) and those managed in the pediatric ICU (PICU) (Group 2). NLR, PLR, and SII calculated from hemogram parameters, as well as arterial blood gas values (pH, serum lactate), C-reactive protein, and procalcitonin (PCT), were analyzed. Their predictive roles in determining disease severity were assessed.

Results

A total of 116 patients were included, of whom 56 (48.3%) were in Group 1 and 60 (51.7%) in Group 2. NLR (p=0.039), PLR (p=0.039), and SII (p=0.026) levels were significantly higher in Group 2. Receiver operating characteristic analysis revealed area under the curve values of 0.718 for NLR, 0.705 for SII, and 0.684 for PLR. NLR, blood pH, serum lactate, and PCT were identified as independent predictors of ICU admission. Hypoxia, comorbid conditions, abnormal vital signs, and elevated inflammatory indices were additional significant risk factors associated with PICU admission.

Conclusion

NLR, PLR, and SII may serve as inexpensive and readily available markers to assess disease severity and predict intensive care needs in pediatric CAP. These indices can support rapid clinical decision-making and facilitate risk stratification in practice.