الفهرس 
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Abstract
Introduction: Critical illness is a complicated condition and still a big challenge to both the developed and developing world. The reported morbidity of critical illness is constantly increasing and remaining among the major causes of death worldwide. Early recognition of sepsis can lead to early treatment and a potential reduction in septic shock development. Aim of the work: Our aim is to determine whether NLR obtained from CBC and with simple calculation can be used to predict mortality in patients with sepsis and septic shock in the ICU as well as its comparability to the ICU severity scores. Subjects and methods: This prospective trial was carried out on 84 ICU cases with severe sepsis. Who were admitted to Specialized Medical Hospital ICU units. All patients were subjected to: full history taking including age, sex, special habits, charlson comorbidity index, vasopressor use, drug abuse& routine physical examination: including inspection, palpation, percussion and auscultation based on the reported symptoms& basic investigations including complete blood count, serum creatinine, urine analysis, liver function tests (albumin, SGOT, SGPT, bilirubin, INR), blood sugar level, blood gases, CRP, APACHEII Score, SOFA Score and NLR calculated, and radiological investigations: including abdominal U/S, ECHO, ECG, chest radiology (chest X-Ray or NCCT chest) were done. Results : Our study shows: ➢ A statistically significantly higher NLR proportion in non-survivors vs. survivors, p value 0.008. ➢ A statistically significantly higher CLD proportion in non-survivors vs. survivors, p value 0.022 ➢ A statistically significantly higher serum bilirubin, INR, TLC, N, NLR, CRP, APACHE II score, and SOFA score, and a statistically significantly lower Systolic blood pressure (mmHg), Diastolic blood pressure (mmHg), GCS, Serum albumin (g/dl), Mean arterial pressure (mmHg) in non-survivors vs. survivors. ➢ No statistically significant difference in Sex, Age, Hypertension, DM, and CKD proportions in non-survivors vs. survivors. ➢ A statistically significantly higher Need for Mechanical Ventilation in group (B) NLR >10 vs. group (A) NLR≤ 10, P value <0.001 Conclusion: Neutrophil -to- lymphocyte ratio (NLR) can be used as a promising prognostic marker in prediction of critical illness severity as well as disease outcome.