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Prognostic value of the neutrophil-to-lymphocyte ratio for predicting hospital length of stay in pneumonia patients: A cross-sectional study

H. Syapitri, Johansen Hutajulu, A. Amila, L. Sinurat, Janno Sinaga, Ivan Elisabeth Purba

Nursing and Health Sciences Journal (NHSJ), 2026

240 participants

Abstract

Pneumonia remains a leading cause of hospitalization and mortality globally, imposing a substantial burden on healthcare systems in developing countries. The Neutrophil-Lymphocyte Ratio (NLR) has emerged as a readily accessible, cost-effective prognostic biomarker for predicting hospital length of stay (LOS). This study aimed to examine the association between NLR and LOS in patients with pneumonia at Melati Perbaungan General Hospital. A cross-sectional study was conducted using medical records of patients with pneumonia treated between January 2024 and January 2025. Of the 240 patients, 102 met the inclusion criteria. Exclusion criteria encompassed immunocompromised conditions, chronic comorbidities, surgical complications, and incomplete records. Data collected included neutrophil and lymphocyte counts, NLR, LOS, age, sex, and treatment modalities. Univariate and bivariate analyses were performed using the Chi-square test (p 3.13) was observed in 80.4% of patients. The majority (77.5%) experienced hospital stays exceeding four days. Significant associations were identified between neutrophil levels (p = 0.038), lymphocyte levels (p = 0.044), and NLR (p = 0.031) with LOS. Patients with elevated NLR demonstrated significantly higher odds of prolonged hospitalization (OR = 5.14). NLR is significantly associated with prolonged hospitalization among patients with pneumonia. This readily accessible biomarker may serve as a cost-effective prognostic indicator to support early…

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 240 participants or records.

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