Monocyte-to-lymphocyte ratio is associated with 28-day mortality in patients with acute respiratory distress syndrome: a retrospective study

Abstract

Background Systemic inflammation relates to the initiation and progression of acute respiratory distress syndrome (ARDS). Neutrophil-to-lymphocyte ratio (NLR) and red blood cell distribution width (RDW)/albumin ratio have been reported to be predictive prognostic biomarkers in ARDS patients. However, the role of monocyte-to-lymphocyte ratio (MLR) as a prognostic inflammatory biomarker in a variety of diseases is rarely mentioned in ARDS. In this study, we explored the relationship between MLR and disease severity in ARDS patients and compared it with other indicators associated with 28-day mortality in patients with ARDS. Methods We retrospectively included 268 patients who fulfilled the Berlin definition of ARDS and were admitted to a single institute from 2016 to 2020. Clinical characteristics and experimental test data were collected from medical records within 24 h after the ARDS diagnosis. MLR, NLR, and RDW/albumin ratio levels were calculated. The primary clinical outcome was 28-day mortality. Logistic regression analysis was used to illustrate the relationship between indicators and 28-day mortality. Receiver operating characteristic (ROC) curve was used to evaluate the area under the curve (AUC), and propensity score matching (PSM) was employed to validate our findings. Results The median MLR values were higher for non-survivors than for survivors before and after matching (P<0.001, P=0.001, respectively). MLR values were significantly associated with 28-day mortality (OR 2.956; 95% CI 1.873–4.665; P<0.001). MLR and NLR indicators were combined for predictive efficacy analysis, and its AUC reached 0.750. There was a significant increase in 28-day mortality depending on the increasing MLR level: low MLR group 38 (20.4%), high MLR group 47 (57.3%) (P<0.001). Conclusions Higher MLR values were associated with 28-day mortality in patients with ARDS. Further investigation is required to verify this relationship with prospectively collected data.

Monocyte-to-Lymphocyte Ratio Was an Independent Factor of the Severity of Spinal Tuberculosis

“…High expression of MLR was detected in inflammatory diseases. High MLR expression was associated with mortality in acute respiratory distress syndrome [23]. MLR was significantly higher in patients with advanced knee synovitis than in early patients [23].…”

Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Can Predict the Severity in COVID-19 Patients from Ethiopia: A Retrospective Study

“…The total platelet count at patient admission 201 (5-528) was increased to 228 (4-531) at discharge (p = 0.027), total leukocyte count (TLC) from 7 (3.4-33) to 9 (1.3-19) (p = 0.005), and absolute lymphocyte count (ALC) from 1 (0.07-301) to 2 (0.5-39) (p = 0.002). Hemoglobin (HB) level at patient admission 14 (4-12.5) was decreased to 13 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) at discharge (p = 0.002), absolute neutrophil count (ANC) from 9 (24-97) to 8 (1-95) (p = 0.004), absolute monocyte count (AMC) from 6 (1-208) to 5 (1-21) (p = 0.001), NLR from 14 (0.4-47) to 9 (0.01-43) (p = 0.001), and PLR from 27 (0.18-232) to 26 (0.94-101) (p = 0.044) (Table 2).…”

“…6 For the prognosis of patients with viral pneumonia, the white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), platelet-tolymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and serum C-reactive protein (CRP) levels were studied as predictors. [7][8][9] Hematological ratios are valuable, affordable prognostic markers that can be widely examined in developing nations with respectable significance in viral pneumonia, particularly COVID-19. 9 In COVID-19 patients and patients with viral pneumonia, the neutrophil-to-lymphocyte ratio (NLR) has been shown to be a useful diagnostic tool and prognostic predictor.…”

Prognostic value of neutrophils to lymphocytes and platelets ratio for 28-day mortality in patients with acute respiratory distress syndrome: a retrospective study

“…Although several studies also reported the predictive prognostic value of NLR in ARDS patients [22][23][24], NLR only reflects the inflammatory and immune status in these patients. In fact, the occurrence and development of ARDS is more complex, which is related to the crosstalk between systemic inflammatory response, abnormal immune regulation, and coagulation dysfunction [25].…”