Admission Neutrophil-Lymphocyte Ratio (NLR) Predicts Survival in Patients with Extensive Burns

Hu, Lunyang; Wang, Baoli; Hong, Yong‐Gang; Xu, Long; Jiang, Yong; Wang, Chen; Zhu, Baorang; Qi, Yu; Hou, Wenjia; Chen, Zhengli; Zhu, Feng; Wu, Guosheng; Sun, Yinghao

doi:10.1016/j.burns.2020.07.028

Cited by 17 publications

(18 citation statements)

References 28 publications

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“…It is possible that our time frame (within 48 h) of “admission” NLR increased the variation so much that the actual effect was blurred. Hu et al showed a marked decrease in NLR over the first three days after injury, from approximately 15 on day 1, to 10 and 9 on the second and third days, respectively 14 which is similar to the figures presented by Qiu et al who also studied more severe burns (53% TBSA%) with NLR levels of 15 on day 1. In their study, however, it was the NLR on day three that was significant (independent factor for 90 day mortality) 40 .…”

Section: Discussionsupporting

confidence: 77%

“…However, in this study despite the significant difference ( p < 0.04) between the a NLR between those dying and survivors, 12.6 and 8.8, respectively, it was not found to affect the mortality prediction on its own, nor did it significantly improve the prediction of mortality when added to the variables of the Baux score. The fact that the burn size was bigger (median 55% TBSA) and the (median) NLR on day 1 was approximately 15 in the cohort studied by Hu et al 14 could explain why we had different results from the regression models, although other studies with burn size and NLR values more similar to ours have also shown NLR to be an independent factor for mortality 38 , 39 . It is possible that our time frame (within 48 h) of “admission” NLR increased the variation so much that the actual effect was blurred.…”

Section: Discussioncontrasting

confidence: 53%

“…Admission Neutrophil to Lymphocyte ratio has been found to be predictive for mortality estimates 14 . This may be anticipated to be so particularly as it has been shown that very high leucocyte counts can be registered early after burns and they correlate to the size of the burn, when there is a flood of leucocytes from the bone marrow into the central circulation 37 .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore recently, three other measures to improve the precision in critical care mortality outcome predictions have been presented and shown to be effective. These are, at admission: a Lactate 12 , Sequential Organ Failure Assessment score ( a SOFA) 13 , and Neutrophil to Lymphocyte ratio ( a NLR) 14 . Each of these scores or measures may be hypothesised to separately and/or in conjunction to the others improve the overall mortality prediction model also in burns who need critical care.…”

Section: Introductionmentioning

confidence: 99%

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Addition of admission lactate levels to Baux score improves mortality prediction in severe burns

Steinvall

Elmasry

Abdelrahman

et al. 2021

Sci Rep

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Risk adjustment and mortality prediction models are central in optimising care and for benchmarking purposes. In the burn setting, the Baux score and its derivatives have been the mainstay for predictions of mortality from burns. Other well-known measures to predict mortality stem from the ICU setting, where, for example, the Simplified Acute Physiology Score (SAPS 3) models have been found to be instrumental. Other attempts to further improve the prediction of outcome have been based on the following variables at admission: Sequential Organ Failure Assessment (aSOFA) score, determinations of aLactate or Neutrophil to Lymphocyte Ratio (aNLR). The aim of the present study was to examine if estimated mortality rate (EMR, SAPS 3), aSOFA, aLactate, and aNLR can, either alone or in conjunction with the others, improve the mortality prediction beyond that of the effects of age and percentage total body surface area (TBSA%) burned among patients with severe burns who need critical care. This is a retrospective, explorative, single centre, registry study based on prospectively gathered data. The study included 222 patients with median (25th–75th centiles) age of 55.0 (38.0 to 69.0) years, TBSA% burned was 24.5 (13.0 to 37.2) and crude mortality was 17%. As anticipated highest predicting power was obtained with age and TBSA% with an AUC at 0.906 (95% CI 0.857 to 0.955) as compared with EMR, aSOFA, aLactate and aNLR. The largest effect was seen thereafter by adding aLactate to the model, increasing AUC to 0.938 (0.898 to 0.979) (p < 0.001). Whereafter, adding EMR, aSOFA, and aNLR, separately or in combinations, only marginally improved the prediction power. This study shows that the prediction model with age and TBSA% may be improved by adding aLactate, despite the fact that aLactate levels were only moderately increased. Thereafter, adding EMR, aSOFA or aNLR only marginally affected the mortality prediction.

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Section: Discussionsupporting

confidence: 77%

Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Addition of admission lactate levels to Baux score improves mortality prediction in severe burns

Steinvall

Elmasry

Abdelrahman

et al. 2021

Sci Rep

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“…A sepse decorrente da síndrome da resposta inflamatória sistêmica (SIRS) é a principal causa de óbito. Esse quadro inflamatório provoca mudanças na contagem de leucócitos, principalmente de neutrófilos e monócitos, podendo os pacientes acometidos apresentarem leucopenia ou leucocitose com desvio à esquerda (Nielson et al, 2017;Hu et al, 2021).…”

Section: Introductionunclassified

Avaliação do perfil hematológico e bioquímico de Tamanduás-bandeira (Myrmecophaga tridactyla) com queimaduras térmicas graves: Relato de seis casos

Magalhães

Mendonça

Zorzo

et al. 2022

RSD

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Incêndios florestais ocorrem anualmente no Pantanal Mato-grossense nos períodos de seca causando morbidade e mortalidade de inúmeras espécies animais, onde os tamanduás-bandeira enquadram-se entre as principais vítimas dessas catástrofes. Devido a difícil criação dessa espécie em cativeiro, há poucos dados na literatura veterinária a respeito dos perfis hematológicos e bioquímicos de tamanduás-bandeira sadios e não há descrição sobre as alterações encontradas nesses animais com lesões térmicas ocasionadas pelo fogo. Portanto, objetivou-se a avaliação dos perfis hematológico e bioquímico de tamanduás-bandeira provenientes de áreas incendiadas do Pantanal (MT) no ano de 2020, assim como a determinação das alterações laboratoriais mais frequentes. No Laboratório de Patologia Clínica Veterinária do HOVET-UFMT foram realizados hemograma completo e bioquímica sérica de amostras sanguíneas de seis indivíduos da espécie Myrmecophaga tridactyla após admissão hospitalar. Dentre os resultados avaliados, observou-se que: 83,3% (5/6) dos animais apresentaram anemia normocítica hipocrômica nos eritrogramas, nos leucogramas 66,7% (4/6) apresentaram desvio à esquerda e neutropenia, além de outros achados predominantes nos hemogramas como hipoproteinemia plasmática total observada em 100% (6/6) dos indivíduos e trombocitose em 66,7% (4/6). Poucas alterações foram observadas na bioquímica sérica, diferentemente dos dados encontrados na literatura humana. Concluiu-se que tamanduás-bandeira com queimaduras térmicas graves apresentam principalmente alterações laboratoriais no hemograma e poucas alterações bioquímicas na primeira avaliação pós- resgate. Salientando assim a necessidade da realização destes exames em vários intervalos de tempo pós lesão para melhor compreensão das alterações laboratoriais sofridas por esses pacientes, haja vista, que todos os indivíduos desse estudo vieram a óbito.

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Blood Count Profiles as Biomarkers in Burns: Red Cells, Platelets, and Beyond

Aramendi,

Angulo,

Burghi

2022

Biomarkers in Trauma, Injury and Critical Care

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Admission Neutrophil-Lymphocyte Ratio (NLR) Predicts Survival in Patients with Extensive Burns

Cited by 17 publications

References 28 publications

Addition of admission lactate levels to Baux score improves mortality prediction in severe burns

Addition of admission lactate levels to Baux score improves mortality prediction in severe burns

Avaliação do perfil hematológico e bioquímico de Tamanduás-bandeira (Myrmecophaga tridactyla) com queimaduras térmicas graves: Relato de seis casos

Blood Count Profiles as Biomarkers in Burns: Red Cells, Platelets, and Beyond

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