Reliability of Haematological Parameters and Ratios Obtained from Automated Haematology Analysers in Predicting the Clinical Condition of the Patient - A Study from a Tertiary Care Hospital in New Delhi


Anjali Sharma1, Manju Kumari2, Heena3, Mukul Singh4, Sunil Ranga5, Jugal Kishore6

Modern automated analysers provide various haematological parameters which
have gained a lot of clinical significance. Of these, platelet indices are the most
recent one which need to be explored in various diseases. The present study was
conducted to evaluate the significance of platelet indices, neutrophil-tolymphocyte
ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and mean platelet
volume–to-platelet count in critically ill patients.
This is a prospective study carried out in emergency laboratory of pathology
department. 100 patients of intensive care units (ICU) and non-intensive care units
(Non-ICU) visiting to the emergency department were included in the study. Fortyfive
age and sex matched control patients were taken. The ethylenediamine tetra
acetic acid (EDTA) blood sample was analysed on automated analyser. Platelet
indices, NLR, MLR and mean platelet volume to platelet counts were calculated in
ICU, Non-ICU and control groups. All these values were compared among these
The study included 400 patients (200 critically ill and 200 non-critically ill) and 45
healthy controls from normal population. The male to female ratio in critically ill
and non-critically ill patients was 1.3 : 1 (113 : 87) and 1.08 : 1 (104 : 96)
respectively. The critically ill patients had significant leucocytosis (P = 0.019) with
neutrophilia (P = 0.005) and lymphopenia (P = 0.048) when compared to noncritically
ill patients. There was a significant difference of NLR (P = 0.010), MLR (P
= 0.027) and MPV : Platelet count (P = 0.045) in these two groups. However,
platelet count and platelet indices were not showing any significant difference in
these groups.
In the era of modern auto analysers, we should try to utilize the maximum
information that could be provided by these machines in forms of various indices
and ratios. The present study highlights that neutrophilic leucocytosis with
lymphopenia is seen in critically ill patients when compared to non-critically ill
patients and normal control population. NLR, MLR and MPV to platelet ratios are
also of great importance whereas platelet count and platelet indices are always
not helpful in categorization of severity of the patient’s condition.