Evaluation of neutrophil-lymphocyte and platelet-lymphocyte ratios as predictors of 30-day mortality in patients hospitalized for an episode of acute decompensated heart failure

Abstract

Summary Background To investigate the association between both neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) and 30-day mortality in patients hospitalized for an episode of acute decompensated heart failure (ADHF). Methods 439 patients admitted to emergency department (ED) for an episode of ADHF. Clinical history, demographic, clinical and laboratory data recorded at ED admission and then correlated with 30-day mortality. Results 45/439 (10.3%) patients died within 30 days from ED admission. The median values of NLR (4.1 vs 11.7) and PLR (159.1 vs 285.9) were significantly lower in survivors than in patients who died. The area under the ROC curve of NLR was significantly higher than that of the neutrophil count (0.76 vs 0.59; p<0.001), whilst the AUC of PLR was significantly better than that of the platelet count (0.71 vs 0.51; p<0.001). In univariate analysis, both NLR and PLR were significantly associated with 30-day. In the fully-adjusted multivariate model, NLR (odds ratio, 3.63) and PLR (odds ratio, 3.22) remained independently associated with 30-day mortality after ED admission. Conclusions Routine assessment of NLR and PLR at ED admission may be a valuable aid to complement other conventional measures for assessing the medium-short risk of ADHF patients.

Role of circulatory leukocyte based indices in short-term mortality of patients with heart failure with reduced ejection fraction

“…Recent evidence showed that high NLR was associated with an increased risk of mortality and complications in post-acute myocardial infarction [ 16 , 17 ]. Turcato et al [ 18 ] showed that the values of NLR and PLR were higher in acute decompensated heart failure patients who died within 30 days…”

The prognostic value of NLR for early death in secondary Hemophagocytic lymphohistiocytosis patients: an analysis of 92 patients

“…Higher NLR was correlated with more advanced disease stage in autoimmune disease [17,18] and it was proved to be an independent prognosis factor in infections disease [11,19], diffuse large B-cell lymphoma [20,21], and so on. Whilst, a higher NLR predicts increased 30-day mortality in critically ill patients [13,22,23]. In this study, we observed that nonsurvivor had a higher NLR compared with survivor, and higher NLR was correlated with older age, longer PT, higher creatinine, and lower HB.…”

The Relationship Between Platelet/Lymphocyte and Neutrophil/Lymphocyte Ratios and Mortality in Intensive Care Patients with Crimean-Congo Hemorrhagic Fever

“…Given that thrombocytopenia is strongly related to the severity of the disease because of its negative clinical outcomes like mild to Several studies have shown that PLR and NLR can be a prognostic tool in the systemic inflammatory response (8)(9)(10)12). Because of the increase in neutrophil numbers and decrease in lymphocyte numbers, NLR may show the severity of immunity depletion and impaired systemic inflammatory response in CCHF.…”

“…Turcato et al (9) found NLR and PLR useful for predicting the 30 day-mortality in acute decompensated heart failure. Mısırlıoğlu et al (10) found PLR as a predictor for mortality in the pediatric intensive care unit.…”

“…In recent years, mortality estimation has been made in some medical situations using the ratio of neutrophil count and platelet count to lymphocyte count, which are among hemogram parameters (8)(9)(10). It is thought that mortality increases due to the disruption between the increased inflammation in the body and the anti-inflammatory mechanism developing against it.…”