Efficacy of blood urea nitrogen and the neutrophil-to-lymphocyte ratio as predictors of mortality among elderly patients with genitourinary tract infections: A retrospective multicentre study

Abstract

Objectives: To investigate whether initial blood urea nitrogen (BUN) and the neutrophil-to-lymphocyte ratio (NLR) in the emergency department (ED) are associated with mortality in elderly patients with genitourinary tract infections. Methods: A total of 541 patients with genitourinary tract infections in 5 EDs between November 2016 and February 2017 were included and retrospectively reviewed. We assessed age, sex, comorbidities, vital signs, and initial laboratory results, including BUN, NLR and the SOFA criteria. The primary outcome was all-cause in-hospital mortality. Results: The nonsurvivor group included 32 (5.9%) elderly patients, and the mean arterial pressure (MAP), NLR and BUN were significantly higher in this group than in the survivor group (p < 0.001, p ¼ 0.003, p < 0.001). In multivariate analysis, MAP <70 mmHg, NLR 23.8 and BUN >28 mg/dl were shown to be independent risk factors for in-hospital mortality (OR 3.62, OR 2.51, OR 2.76: p ¼ 0.002, p ¼ 0.033, p ¼ 0.038, respectively). Additionally, NLR 23.8 and BUN >28 were shown to be independent risk factors for mortality in admitted elderly with complicated UTI (p ¼ 0.030, p ¼ 0.035). When BUN and NLR were combined with MAP, the area under the ROC curve (AUROC) value was 0.807 (0.771e0.839) for the prediction of mortality, the sensitivity was 87.5% (95% CI 71.0e96.5), and the specificity was 61.3% (95% CI 56.9e65.5%). Conclusion: The initial BUN and NLR values with the MAP were good predictors associated with all-cause in-hospital mortality among elderly genitourinary tract infections visiting the ED.

Neutrophil-to-lymphocyte ratio is a marker for acute kidney injury progression and mortality in critically ill populations: a population-based, multi-institutional study

“…NLR could also be used as a prognostic marker in various diseases (including pulmonary embolism, pancreatitis, sepsis, etc. ), and some studies have demonstrated a linear relationship [13][14][15][16][17]24]. Other studies have demonstrated J-shaped relationships of NLR and cortisol levels with patient survival [18,37].…”

“…It is a surrogate marker of systemic response to physiological stress. NLR is associated with adverse outcomes in many diseases [13][14][15][16][17][18][19] and can help in early predicting AKI [20][21][22]. In a study of 10,859 patients admitted to an intensive care unit (ICU), Zheng et al [23] noted that platelet-to-lymphocyte ratio, an inflammatory marker similar to NLR, exhibited a U-shaped relationship with mortality in patients with critical illness and AKI.…”

Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio, Novel Biomarkers and Applications in Urology: An Update

“…In this study, the NLR ≥ 23.8 predicted all resulted in death at elderly UTI patient, with the sensitivity of 38% and specificity about 88%. When the BUN and NLR were combined with MAP for mortality prediction, the sensitivity was equivalent to Sequential organ failure asessment score (SOFA) at 87.5%, and the specificity was 61% greater than SOFA [24].…”

Korelasi Rasio Neutrofil Limfosit dengan Lama Rawat Inap

“…4 Rasio Neutrofil Limfosit (RNL) adalah indikator sederhana yang mudah diakses hanya dengan melihat hasil hitung darah lengkap dan menggambarkan status inflamasi sistemik pasien. 5 Hitung darah lengkap selalu dilakukan pada seseorang yang dirawat inap di rumah sakit. Salah satu reaksi fisiologis sistem imunitas terhadap inflamasi sistemik adalah peningkatan jumlah neutrofil dan penurunan jumlah limfosit.…”