J Pediatr Infect Dis 2018; 13(04): 268-273
DOI: 10.1055/s-0038-1657784
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Independent Predictors of Severity and Hospitalization in Acute Bronchiolitis: Neutrophil/Lymphocyte Ratio and Mean Platelet Volume

Ali Gul
1   Gaziosmanpasa University School of Medicine Department of Pediatrics, Tokat, Turkey
Şahin Takçı
1   Gaziosmanpasa University School of Medicine Department of Pediatrics, Tokat, Turkey
Buket Altıntaş Seyyah
2   Tokat State Hospital Department of Pediatrics, Tokat, Turkey
Resul Yılmaz
3   Selcuk University School of Medicine Department of Pediatrics, Konya, Turkey
› Author Affiliations
Further Information

Publication History

08 December 2017

29 April 2018

Publication Date:
02 June 2018 (online)


Background and Aim Acute bronchiolitis is the most common cause of hospitalization in the first year of life. The neutrophil/lymphocyte ratio (NLR) and mean platelet volume (MPV) are readily calculable laboratory markers used to evaluate systemic inflammation. We aim to evaluate the optimal values of these markers for the prediction of severity and hospitalization in infants with acute bronchiolitis.

Materials and Methods A total of 105 patients with acute bronchiolitis and 62 healthy controls aged 1 to 12 months were prospectively enrolled to the study. The patients' group was classified into two groups, namely, outpatient and inpatient, also divided into three groups according to clinical scoring: mild, moderate, and severe. The association of NLR and MPV with clinical severity and hospitalization was investigated.

Results The mean age was 7.75 ± 2.98 months in patients and 7.69 ± 2.87 months in controls. The means of NLR were 0.47 and 0.64 in controls and patients, respectively (p = 0.032) and of MPV were 9.64 and 8.9 (p < 0.001), respectively. The means of NLR were 0.73 and 0.50 in inpatient and outpatient groups, respectively (p = 0.014) and of MPV were 8.65 and 9.32 (p = 0.046), respectively. NLR of 0.64 value was calculated as a cutoff for the prediction of hospitalization with 45% sensitivity and 83% specificity (positive predictive value = 81%, negative predictive value = 19%).

Conclusion We found that blood neutrophil percentage and blood NLR are increased and also weakly predictive—but insufficient to be clinically useful—for the decision of hospitalization in acute bronchiolitis. When the positive predictive value of an NLR of 0.64 is sufficient to decide hospitalization, the negative predictive value is impractical. MPV value was less in infants with acute bronchiolitis than healthy controls and in inpatients than outpatients with acute bronchiolitis. Low MPV might be marker of inflammation in acute bronchiolitis.