Multi-institutional analysis of neutrophil-to-lymphocyte ratio (NLR) in patients with severe hemorrhage: A new mortality predictor value

Duchesne, Juan; Tatum, Danielle; Jones, G. Wynne; Davis, Brandy; Robledo, Rosemarie; DeMoya, Marc; OʼKeeffe, Terence; Ferrada, Paula; Jacome, Tomas; Schroll, Rebecca; Wlodarczyk, Jordan; Prakash, Priya; Smith, Brian R.; Inaba, Kenji; Khor, Desmond; Duke, Marquinn; Khan, M. Shahnawaz

doi:10.1097/ta.0000000000001683

Cited by 25 publications

(29 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Duchesne j. et al hypothesized that the NLR would be a prognostic indicator of mortality in this population. At the end of their study, they found that NLR is strongly associated with early mortality in patients with severe hemorrhage managed with massive transfusion protocol [10].…”

Section: Discussionmentioning

confidence: 97%

“…Recently, NLR, which is considered as a strong visual fi eld of infl ammation, has been shown in many studies that can be used to predict prognosis in many diseases such as cancer, cardiac, autoimmune [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. NLR is the ratio of absolute neutrophil count to the absolute lymphocyte count.…”

Section: Discussionmentioning

confidence: 99%

“…The R-Baux score has been used for many years for estimating the risk of mortality in severely burned patients [4]. In a number of recent publications, it has been stated that the NLR which is cheap and easily calculated at every center, is a strong indicator of infl ammation in many diseases such as cancer, cardiac, and autoimmune diseases, and can be used for estimating the prognosis of the patient [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. So we also aimed to reveal the relationship between mortality and NLR in cases that treated in our center.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Could neutrophil-to-lymphocyte ratio be a new mortality predictor value in severe burns?

Ali¹

2019

J Surg Surgical Res

View full text Add to dashboard Cite

Background: The aim of our study was to demonstrate if there is any relation between the neutrophilto-lymphocyte ratio (NLR) and mortality in severe burns. Methods: The records of 366 patients who were admitted to Intensive Care Unit of Burn Center of Derince Training and Research Hospital between January 2012 and December 2015 were evaluated retrospectively. The cases who were hospitalized in service or did not require intensive care were not included in the study. The cases were divided into two groups: ex-group (Group 1) and discharge group (Group 2). In both groups demographic information such as age, gender, burn scores, neutrophil counts and lymphocyte counts during admission to the hospital were recorded. NLR is the ratio of absolute neutrophil count to the absolute lymphocyte count. Results: NLR was 10.94±7.63 in the exitus group and 5.5±5.56 in the discharged group. NLR was increased in mortality group and this value was statistically signifi cant (p=0.00). Independent relationship between prognoses and NLR was shown with logistic regression analyses (Odds Ratio 0.895, 95% confi dence interval 0.856-0.936, p=0.00) Conclusion: NLR has increased in mortality group. Our study showed that NLR is correlated with probability of mortality after severe burn injuries. Therefore, it can be used as a cheap, easily obtained and new mortality predictor in severe burns.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Could neutrophil-to-lymphocyte ratio be a new mortality predictor value in severe burns?

Ali¹

2019

J Surg Surgical Res

View full text Add to dashboard Cite

show abstract

“…A recent study had found that a trajectory of increasing NLR over the first 48 h of admission is associated with the development of organ failure among male trauma patients [10]. Another study realizes that NLR is strongly associated with early mortality in trauma patients with severe hemorrhage managed with multi-transfusion protocol (MTP) [11]. According to Dilektasli et al who demonstrated the prognostic role of NLR at days 2 and 5 in predicting hospital deaths in trauma patients, in contrast, the NLR in the first 24 h was not useful for predicting outcomes when compared with the next days in the surgical intensive care unit [12]; in this study, hospital days 2 and 5 revealed optimal cutoff values of 8.19 and 7.92, corresponding to a sensitivity and specificity of 70.8% and 61.9% and 75.6% and 66.9%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Cohort retrospective study: the neutrophil to lymphocyte ratio as an independent predictor of outcomes at the presentation of the multi-trauma patient

et al. 2020

View full text Add to dashboard Cite

Background: Although the association of neutrophil to lymphocyte ratio (NLR) with mortality in trauma patients has recently been shown, there is a paucity of research on the association with other outcomes. Recent studies suggest that the NLR has a predictive value of mortality in trauma patients during various times of admission. This study aimed to determine the prognostic impact of NLR at the presentation in critically ill trauma patients. Methods: A retrospective cohort study of adult trauma patients between July 2017 and November 2017 in Tishreen Hospital. All patients who had arrived at the emergency department with multi-trauma injury within the age category (14-80 years) were included in this analysis. The prophetical capability of NLR on mortality was assessed by the receiver operative characteristics (ROC) curve. To identify the impact of the NLR on survival, a separate log-rank test was used. Multivariable Cox proportional hazard modeling was used to identify independent predictors of mortality. Results: Throughout the time of the study, 566 patients met the inclusion criteria. Of these, 98.8% were male, 75.8% sustained penetrating trauma, and median age [IQR25-IQR75] was 26 [23-32]. Ninety-seven patients (17.1%) had major trauma, with an Injury Severity Score (ISS) ≥ 15. Using the ROC curve analyses hospitalization day 1, optimal NLR cutoff values of 4.00 were calculated by maximizing the Youden index. Kaplan-Meier curves revealed an NLR greater than or equal to these cutoff values as a marker for increased in-hospital mortality (p = 0.020, log-rank test). The Cox regression model demonstrated significant collinearity among the predictive variables (all VIF results < 2). Only ISS > 15 has a significant statistical relation with elevated NLR on day 1 (p = 0.010). Conclusions: Elevated NLR on day 1 has high predictive power for overall survival during the first 30 days after trauma, but it was not independent of other factors.

show abstract

“…Due to the fundamental meaning of these ratios, reflecting an inflammatory load, they are frequently reported and tested as prognostic factors in several medical disciplines. Numerous publications (only a few recent articles are quoted) investigated these measures in cardiology [ 1 ], oncology [ 2 ], surgery [ 3 ], and gastroenterology [ 4 ], often incorporating them into the prognostic algorithm [ 5 – 8 ]. In the gynecology-related literature, NLR and PLR were evaluated in gynecological cancers [ 9 ] and in reproductive morbidities such as ovarian hyperstimulation syndrome [ 10 ], premature ovarian insufficiency [ 11 ] and endometriosis [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Neutrophils to lymphocytes ratio and platelets to lymphocytes ratio in pregnancy: A population study

et al. 2018

View full text Add to dashboard Cite

BackgroundNeutrophils to lymphocytes ratio (NLR) and platelets to lymphocytes ratio (PLR) are both inflammatory ratios that can be easily calculated from a simple blood count. They are frequently reported and tested as prognostic factors in several medical disciplines. Pregnancy involves special reference values for laboratory assays.ObjectiveThe aim of this study was to define pregnancy-related reference values for NLR and PLR according to trimester, background morbidity and according to the patient's age.Study designA retrospective analysis of a large cohort undergoing community-based pregnancy surveillance between the years 2011–2016. Data were analyzed according to high-risk patient versus normal-risk patient.ResultsA total of 11,415 patients were included. Mean PLR and NLR values were 136.3±44.3, 2.6±1, respectively during the first trimester, 144.6±47.1, 4.0±1.4 respectively during the second trimester and 118.1±42.0, 3.5±1.2 respectively during the third trimester. No difference was detected between the high-risk and the normal population (P-values 0.3, 0.5 and 0.4 for PLR in each trimester respectively and 0.3, 0.4, 0.6 for NLR in each trimester, respectively). No differences were detected among parity categories. The correlation between patient’s age and either PLR and NLR was a weak positive correlation (though statistically significant). Both PLR and NLR reached a maximum value during the second trimester. The differences between mean NLR and PLR between trimesters were significant (P <0.01 for all differences tested). PLR rises in the presence of anemia, reaching statistical significance (P-value for PLR in each trimester was <0.01). NLR showed an opposite trend (P-values for NLR were 0.4, 0.005 and 0.06 in each trimester, respectively).ConclusionsIn our cohort, there were generally no differences between the high-risk and the normal population, excluding patients with a fibroid uterus or inflammatory bowel disease who presented a significantly elevated PLR through all trimesters. Both PLR and NLR reached a maximum value during the second trimester and were positively correlated with age. We anticipate that the population-based data will assist in providing accurate reference values for future research testing NLR and PLR measures during pregnancy.

show abstract

Multi-institutional analysis of neutrophil-to-lymphocyte ratio (NLR) in patients with severe hemorrhage: A new mortality predictor value

Abstract: Prognostic study, level III.

Cited by 25 publications

References 27 publications

Could neutrophil-to-lymphocyte ratio be a new mortality predictor value in severe burns?

Could neutrophil-to-lymphocyte ratio be a new mortality predictor value in severe burns?

Cohort retrospective study: the neutrophil to lymphocyte ratio as an independent predictor of outcomes at the presentation of the multi-trauma patient

Neutrophils to lymphocytes ratio and platelets to lymphocytes ratio in pregnancy: A population study

Contact Info

Product

Resources

About