Platelet-lymphocyte ratio (PLR) and all-cause mortality in general population: insights from national health and nutrition education survey

Mathur, Kanupriya; Kurbanova, Nargiza; Qayyum, Rehan

doi:10.1080/09537104.2019.1571188

Cited by 30 publications

(18 citation statements)

References 42 publications

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“…Likewise, deceased patients had significantly higher platelet counts and PLR level, and lower lymphocyte counts than alive patients. Similar to our study, Mathur et al [ 19 ] observed that mean PLR was significantly higher in general population who died than those who were living, and participants in the fourth quartile of PLR were at significantly higher risk of mortality than those in the first quartile (19.8 vs. 13.9 per 1000 person-years).…”

Section: Discussionsupporting

confidence: 91%

“…First, hip fractures occur commonly in the elderly, and the average age was 79.31 years in our study. A recent study has demonstrated that elevated PLR was associated with increased all-cause mortality in the elderly but not in the middle age or younger participants [19]. Second, about 34.08% elderly hip fracture patients suffered chronic obstructive pulmonary disease (COPD) [36], and high PLR was significantly associated with both hospital mortality and 90-day mortality in patients with COPD [30,37].…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, elevated PLR was found to be significantly associated with increased all-cause mortality in general population, especially in the elderly [19]. However, none studies have examined the relationship between PLR and all-cause mortality in elderly hip fracture patients.…”

Section: Introductionmentioning

confidence: 85%

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High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

Wang¹,

Wang²,

Yang³

et al. 2020

International Orthopaedics (SICOT)

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Purpose The platelet-to-lymphocyte ratio (PLR) has been extensively studied in various diseases. However, the relationship between PLR and hip fracture remains unknown. The aim of this study was to evaluate whether PLR would be an independent prognostic factor in elderly hip fracture patients. Methods Between January 2014 and December 2018, a retrospective cohort study was conducted in a orthopaedic centre, China. A total of 460 hip fracture patients were included. PLR was calculated as the ratio of platelet to lymphocyte counts and divided into high PLR group (≥ 189) and low PLR group (< 189) by using the receiver operating characteristic (ROC) curve. The relationship between PLR and one year all-cause mortality rate was assessed by univariate and multivariate Cox proportional hazard models. Further subgroup analysis stratified by different clinical and biological characteristics was performed to make the results more accurate. Results After a median follow-up of 32.0 months (range, 12.0-75.4), 92 patients (mortality rate: 20.0%) died within one year. PLR was significantly higher in dead patients compared with alive patients (p < 0.05), and high PLR group also had a high mortality rate (32.21% vs. 14.15%, p < 0.001). After multivariate adjustment, high PLR remained an independent predictor for one year all-cause mortality (adjusted hazard ratio (HR) 1.56, 95% confidence interval (CI) 1.02-2.41, p = 0.041). Moreover, advanced age (HR 1.05, 95% CI 1.01-1.08), male (HR 1.62, 95% CI 1.06-2.45), CCI ≥ 2 (HR 2.83, 95% CI 1.64-4.89), conservative treatment (HR 5.94, 95% CI 3.71-9.73), low haemoglobin level (HR 1.02, 95% CI 1.01-1.04), and low albumin level (HR 1.07, 95% CI 1.02-1.13) were independent risk factors for survival. Furthermore, subgroup analysis results were consistent with the main findings in most stratified groups. Conclusion This study highlights that high PLR (≥ 189) is associated with increased one year all-cause mortality in elderly hip fracture patients. As PLR is a simple indicator that can be calculated from the blood routine test, it can be easily performed in usual clinical practice.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

Wang¹,

Wang²,

Yang³

et al. 2020

International Orthopaedics (SICOT)

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“…Indicators for assessing the systemic inflammation have received increased attention and are valuable for predicting clinical outcomes in practice. 32–34 The previous studies reported that C-reactive protein may be a death prognosis factor in general people 35 and in patients with cardiovascular disease, 35 , 36 lung cancer, 37 or colorectal cancer. 38 Erythrocyte sedimentation rate is also a potential marker for mortality in general people 39 and in patients with nontuberculous mycobacterial pulmonary disease.…”

Section: Discussionmentioning

confidence: 99%

Association Between Neutrophil-Lymphocyte Ratio and All-Cause Mortality and Cause-Specific Mortality in US Adults, 1999–2014

Chen¹,

Wang²,

Zeng³

et al. 2021

IJGM

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Background Neutrophil-lymphocyte ratio (NLR) is a novel marker of inflammation. Emerging studies have evaluated the relationship of NLR with cardiovascular diseases and malignant conditions. However, rare studies regarded the association between NLR and long-term health status. This study aimed to evaluate the association of NLR with all-cause mortality and cause-specific mortality among adults in the United States. Methods We obtained eight cycles data of National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2014, and enrolled 32328 participants after certain screening. By weighted chi-square test and linear regression analysis, we analyzed the correlation between NLR and baseline characteristics of the participants. Kaplan–Meier curves and Cox regression models were used to assess the survival relevance of NLR. We conducted stratified analysis, interaction analysis, and sensitivity analysis to robustness of our results. Results Participants with high NLR levels had a higher risk of death. After adjustment for baseline characteristics, the hazard ratio comparing the higher vs lower NLR levels was 1.43 (95% CI, 1.18–1.73) for all-cause mortality, 1.27 (95% CI, 0.84–1.92) for cancer mortality, and 1.44 (95% CI, 0.96–2.16) for cardiovascular disease mortality. Stratified analysis found that the observed associations between NLR levels and mortality did not differ significantly. Conclusion In this nationally representative cohort of US adults, higher NLR was significantly associated with an increased risk of all-cause mortality.

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“…A combination of these immune markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII), is thought to better reflect alterations in the immune system [ 11 , 12 ]. Evidence from observational studies has demonstrated a significant association of these circulatory markers of immunity with increased risks of dementia [ 13 ], cardiovascular disease [ 14 ] and mortality [ 15 , 16 ] in older adults. Meanwhile, several studies have indicated a significant association of immune markers with frailty in specific populations, such as patients with coronary heart disease [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Association of immunity markers with the risk of incident frailty: the Rugao longitudinal aging study

Zhang

Meng

et al. 2022

Immun Ageing

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Background The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) are readily available circulatory immunity markers that are associated with components of frailty. However, few studies have investigated the relationship between these immunity markers and frailty, and it remains unknown whether they are predictive of incident frailty in older adults in general. Hence, we aimed to examine the association of these immunity markers with the risk of incident frailty. Results Overall, 1822 older adults (mean age was 78.03 ± 4.46 years) were included in the Rugao Longitudinal Aging Study. NLR, PLR and SII were calculated from blood cell counts. The frailty definition was based on the Fried phenotype. At baseline, 200 (10.98%) individuals were defined as frailty, and no significant associations of NLR, PLR and SII with frailty were found. During the 2-year follow-up, 180 (15.67%) individuals were new-onset frailty. After adjustment, an increased logNLR (odds ratio [OR] 2.92, 95% confidence interval [CI] 1.20–7.18), logPLR (OR 2.54, 95% CI: 1.01–6.53) and logSII (OR 2.34, 95% CI: 1.16–4.78) were significantly associated with a higher risk of incident frailty in all individuals. Additionally, the associations of logNLR (OR 4.21, 95% CI 1.54–11.62 logPLR (OR 3.38, 95% CI: 1.17–9.91) and logSII (OR 2.56, 95% CI: 1.15–5.72) with incident frailty were remained after excluding individuals with comorbidities. In further analyzed, individuals with higher levels of NLR and SII had higher risk of incident frailty when we stratified individuals by quartiles of these immunity markers. Conclusion NLR and SII are easily obtained immunity markers that could be used to predict incident frailty in clinical practice.

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Platelet-lymphocyte ratio (PLR) and all-cause mortality in general population: insights from national health and nutrition education survey

Cited by 30 publications

References 42 publications

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

Association Between Neutrophil-Lymphocyte Ratio and All-Cause Mortality and Cause-Specific Mortality in US Adults, 1999–2014

Association of immunity markers with the risk of incident frailty: the Rugao longitudinal aging study

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