Plasma Neutrophil-to-Lymphocyte Ratio on the Third Day Postburn is Associated with 90-Day Mortality Among Patients with Burns Over 30% of Total Body Surface Area in Two Chinese Burns Centers

Abstract

Introduction Neutrophil-to-lymphocyte ratio (NLR) is a marker of inflammation. This study aimed to evaluate the potential role of NLR to predict 90-day mortality. Methods Data of 577 patients with burns over 30% of total body surface area were collected and retrospectively analyzed. The risk factors for 90-day mortality were evaluated using logistic regression analyses. Receiver operating characteristic (ROC) curve analysis of the 3rd day NLR was performed and the optimal cut-off value was calculated. The 90-day mortality rates were compared between high and low NLR groups using Kaplan-Meier analysis. Results Age, mechanical ventilation, burn index, 3rd day NLR, and 7th day red blood cell and platelet (PLT) counts were found to be independent predictive values for 90-day mortality. In contrast, percentage of total body surface area burned, inhalation injury, 1st day white blood cell and neutrophil counts, the 3rd day lymphocytes and PLT counts, and 7th day hemoglobin level were not independently associated with 90-day mortality. The area under the ROC curve of the 3rd day NLR for severe burn–delayed death prediction was 0.665 (95% confidence interval, 0.591–0.739), and the optimal cut-off value of the 3rd day NLR was 10.50. The 90-day mortality rates differed significantly between the NLR >10.5 group and the NLR ≤ 10.5 group (17.03% vs 5.92%, respectively; P < 0.01). Conclusion These results suggested that the 3rd day NLR was associated with an increased risk of death in severely burned patients; thus, it can provide useful information to predict 90-day mortality.

High neutrophil-lymphocyte ratio as a predictor of mortality in major burn patients

“…These results agree with the previous findings of Qiu et al, who found a relationship between the value of the neutrophil-lymphocyte ratio and mortality in patients with major burns on day 3. (Qiu et al, 2021). The results of multivariate Analysis found that the third-day neutrophil-lymphocyte ratio value greater than or equal to 10 was an independent risk factor for mortality with an AOR of 13.91 (95% CI 1.77 -109.47).…”

“…Subjects were then categorized based on the intersection points identified by Qiu et al (2021)in previous research. The results of this categorization were then entered in the cross-tabulation table (Table 2) and continued with Chi-squared and Fisher's exact tests.…”

Peripheral blood indices to predict PFS/OS with anlotinib as a subsequent treatment in advanced small-cell lung cancer

“…No more than 1 week prior to enrollment, the baseline hematological index was collected, including routine blood examination, biochemical data, blood coagulation indices, etc. We adopted the commonly used method of using a receiver operating characteristic (ROC) curve to calculate cut-off values for survival [8][9][10][11][12] . PFS and OS measurements were obtained using survival status (dead or alive), and imaging findings were used to determine condition (progression or stable) at the end of the follow-up; these measurements were considered as outcome variables and were also compared to their respective normal clinical values to confirm reliability.…”

Addition of admission lactate levels to Baux score improves mortality prediction in severe burns

“…Hu et al showed a marked decrease in NLR over the first three days after injury, from approximately 15 on day 1, to 10 and 9 on the second and third days, respectively 14 which is similar to the figures presented by Qiu et al who also studied more severe burns (53% TBSA%) with NLR levels of 15 on day 1. In their study, however, it was the NLR on day three that was significant (independent factor for 90 day mortality) 40 .…”