Association between Novel Marker (Platelet-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio, and Delta Neutrophil Index) and Outcomes in Sudden Cardiac Arrest Patients

Abstract

Purpose. It is important that clinicians accurately predict the outcome of patients with sudden cardiac arrest (SCA). The complete blood count (CBC) is an easy and inexpensive test that provides information on blood content. Platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and delta neutrophil index (DNI) are relatively novel biomarkers that have been used in the prognosis of various diseases. We aimed to determine the usefulness of PLR, NLR, and DNI in predicting the outcomes of SCA. Materials and Methods. This retrospective observational study was performed on patients with SCA. Patients who visited the tertiary university hospital from January 2015 to December 2019 were targeted. The inclusion criteria were all nontraumatic adult out-hospital cardiac arrest patients. We analyzed DNI, PLR, and NLR based on the CBC results of all enrolled patients. The exclusion criteria were as follows: no data on laboratory study, traumatic arrest, age < 18 years, and a history of leukemia, myelodysplastic syndrome, and myelofibrosis. The primary outcome was assessed as return of spontaneous circulation (ROSC), the secondary outcome as survival to discharge, and the tertiary outcome as neurological outcome. Results. From January 1, 2015, to December 31, 2019, 739 patients were enrolled. ROSC was seen in 324 patients, of whom 60 had survival to discharge and 24 had good neurological outcome at the time of discharge (cerebral performance categories (CPCs) 1-2). The PLR of the ROSC group was 42.41 (range: 4.21–508.7), which was higher than that of the No-ROSC group ( p = 0.006 ). The DNI value of the survival group was 0.00 (range: 0.00–40.9), which was lower than that of the nonsurvival group. Conclusions. Patients with SCA and subsequent ROSC had higher PLR and NLR, while those with survival to discharge had lower DNI values than those with nonsurvival to discharge ( p = 0.005 ).

Intra‐arrest blood‐based biomarkers for out‐of‐hospital cardiac arrest: A scoping review

“…After applying all inclusion and exclusion criteria, 118 studies were included in the scoping review, as shown in Figure 1 . 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ,…”

“…The search strategy identified a total of 11,834 records, of which 6914 were non‐duplicates. After applying all inclusion and exclusion criteria, 118 studies were included in the scoping review, as shown in Figure 1 11–128 …”

The ‘analysis of gene expression and biomarkers for point-of-care decision support in Sepsis‘ study; temporal clinical parameter analysis and validation of early diagnostic biomarker signatures for severe inflammation andsepsis-SIRS discrimination

“…These may be molecular signatures referencing a neutrophil-to-lymphocyte ratio imbalance (NLR). NLR is a well-documented feature of many severe inflammatory conditions including sepsis ( 76 ), heart failure and other conditions ( 77 ), trauma ( 78 , 79 ) and cardiac arrest ( 80 – 83 ) and is indicative of a poor outcome. Elevated neutrophil and reduced lymphocyte counts have been associated with poor outcomes in emergency medicine in general ( 84 ).…”

Association of B-Type Natriuretic Peptide Level with Clinical Outcome in Out-of-Hospital Cardiac Arrest in Emergency Department Patients

“…The prognosis of SCAs can help physicians during triage, treatment, and overall related management [7]. Biomarkers represent an area of growing interest in this field as they may provide clinicians with early information on the severity of organ dysfunction and enable them to make decisions on clinical strategies and evaluate potential outcomes [8,9]. Similar to worldwide findings, noncardiac causes of SCA are more common in Korea [10].…”