Prognostic value of neutrophil/lymphocyte ratio and mean platelet volume/platelet ratio for 1-year mortality in critically ill patients

Ham, Sung Yeon; Yoon, Hei Jin; Nam, Seok Woo; Yun, Byung Hwan; Eum, Darhae; Shin, Cheung Soo

doi:10.1038/s41598-020-78476-y

Cited by 14 publications

(8 citation statements)

References 35 publications

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“…NLR is a reflection of physiological stress and a marker of the interaction between different immune pathways. NLR was shown to be an independent predictor of in-hospital mortality for many cardiovascular, neurovascular, and intensive-care conditions [17,18], and high NLR values can be observed in very heterogenous diseases and conditions. This is why NLR is generally considered a marker of physiologic stress among hospitalized patients.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of In-Hospital Mortality in Patients with Acute Intracerebral Hemorrhage

et al. 2021

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Background and Objectives: Neutrophil-to-lymphocyte ratio (NLR), a very low cost, widely available marker of systemic inflammation, has been proposed as a potential predictor of short-term outcome in patients with intracerebral hemorrhage (ICH). Methods: Patients with ICH admitted to the Neurology Department during a two-year period were screened for inclusion. Based on eligibility criteria, 201 patients were included in the present analysis. Clinical, imaging, and laboratory characteristics were collected in a prespecified manner. Logistic regression models and receiver operating characteristics (ROC) curves were used to assess the performance of NLR assessed at admission (admission NLR) and 72 h later (three-day NLR) in predicting in-hospital death. Results: The median age of the study population was 70 years (IQR: 61–79), median admission NIHSS was 16 (IQR: 6–24), and median hematoma volume was 13.7 mL (IQR: 4.6–35.2 mL). Ninety patients (44.8%) died during hospitalization, and for 35 patients (17.4%) death occurred during the first three days. Several common predictors were significantly associated with in-hospital mortality in univariate analysis, including NLR assessed at admission (OR: 1.11; 95% CI: 1.04–1.18; p = 0.002). However, in multivariate analysis admission, NLR was not an independent predictor of in-hospital mortality (OR: 1.04; 95% CI: 0.9–1.1; p = 0.3). The subgroup analysis of 112 patients who survived the first 72 h of hospitalization showed that three-day NLR (OR: 1.2; 95% CI: 1.09–1.4; p < 0.001) and age (OR: 1.05; 95% CI: 1.02–1.08; p = 0.02) were the only independent predictors of in-hospital mortality. ROC curve analysis yielded an optimal cut-off value of three-day NLR for the prediction of in-hospital mortality of ≥6.3 (AUC = 0.819; 95% CI: 0.735–0.885; p < 0.0001) and Kaplan–Meier analysis proved that ICH patients with three-day NLR ≥6.3 had significantly higher odds of in-hospital death (HR: 7.37; 95% CI: 3.62–15; log-rank test; p < 0.0001). Conclusion: NLR assessed 72 h after admission is an independent predictor of in-hospital mortality in ICH patients and could be widely used in clinical practice to identify the patients at high risk of in-hospital death. Further studies to confirm this finding are needed.

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Section: Discussionmentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of In-Hospital Mortality in Patients with Acute Intracerebral Hemorrhage

et al. 2021

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“…Before and independently of the COVID-19 outbreak, evidence was provided in support of the involvement of exaggerated pro-inflammatory activation of neutrophils, accompanied by the release of cytotoxic NETs, in the pathogenesis of clinical derangements present in critically ill patients ( 4 , 22 – 24 ). High NLR, neutrophil percentage-to-albumin ratio (NPAR), neutrophil-to-albumin ratio (NAR), neutrophil-derived enzyme myeloperoxidase, IL-8, and NETs have been reported as indicators of severe disease and poor outcomes in cardiogenic and septic shock, in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), in disseminated intravascular coagulation, and in acute kidney injury ( 22 , 25 – 42 ).…”

Section: Introductionmentioning

confidence: 99%

The effect of reparixin on survival in patients at high risk for in-hospital mortality: a meta-analysis of randomized trials

et al. 2022

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IntroductionA great number of anti-inflammatory drugs have been suggested in the treatment of SARS-CoV-2 infection. Reparixin, a non-competitive allosteric inhibitor of the CXCL8 (IL-8) receptors C-X-C chemokine receptor type 1 (CXCR1) and C-X-C chemokine receptor type 2 (CXCR2), has already been tried out as a treatment in different critical settings. Due to the contrasting existing literature, we decided to perform the present meta-analysis of randomized controlled trials (RCTs) to investigate the effect of the use of reparixin on survival in patients at high risk for in-hospital mortality.MethodsWe created a search strategy to include any human RCTs performed with reparixin utilization in patients at high risk for in-hospital mortality, excluding oncological patients. Two trained, independent authors searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) for appropriate studies. Furthermore, references of review articles and included RCTs were screened to identify more studies. No language restrictions were enforced. To assess the risk of bias of included trials, the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) was used.ResultsOverall, six studies were included and involved 406 patients (220 received reparixin and 186 received the comparator). The all-cause mortality in the reparixin group was significantly lower than that in the control group [5/220 (2.3%) in the reparixin group vs. 12/186 (6.5%) in the control group, odds ratio = 0.33 (95% confidence interval 0.12 to 0.96), p-value for effect 0.04, p for heterogeneity 0.20, I2 = 36%]. In addition, no difference in the rate of pneumonia, sepsis, or non-serious infections was shown between the two groups.ConclusionOur meta-analysis of randomized trials suggests that short-term inhibition of CXCL8 activity improved survival in patients at high risk for in-hospital mortality without increasing the risk of infection.Meta-analysis registrationPROSPERO, identifier CRD42021254467.

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“…In our study, the value found for NRL in critically ill patients with active and inactive cancer was 21 (the 3 rd tertile). Ham et al (2020), when analyzing 1154 patients admitted to an ICU, found that the incidence of one-year mortality was significantly higher in the 3rd tertile (NLR = 24.28 ± 22.48; p < 0.001). However, this was not confirmed in our research.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of inflammatory indices: a prospective study in critical oncological patients

Pedrosa¹,

Martucci

Oliveira

et al. 2022

CONJ

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The aim of this study was to evaluate the association of inflammatory indices and survival in critical cancer patients. This is a prospective, observational cohort study in which patients were followed up for 28 days after admission to the intensive care unit (ICU) of a reference hospital specialized in oncology. The neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), and modified Glasgow Prognostic Score (mGPS) were calculated within 24 hours of admission to the ICU. Spearman’s correlation, Kaplan-Meier survival curve, and Cox regression were used to associate the selected variables with survival. One hundred patients were selected, 78% of whom had active cancer, and 27 of whom died. Patients with mGPS 1 and 2 had a lower probability of 28-day survival and were 4.1 times more likely to die than the patients with mGPS 0. mGPS is a better predictor of survival than NLR, PLR, and MLR in critically ill patients diagnosed with solid tumors. Further studies are needed to establish the precise cutoff point for mGPS in relation to mortality and to assess its applicability in clinical practice. Keywords: inflammation; critical care; neoplasms; prognosis.

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Prognostic value of neutrophil/lymphocyte ratio and mean platelet volume/platelet ratio for 1-year mortality in critically ill patients

Cited by 14 publications

References 35 publications

Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of In-Hospital Mortality in Patients with Acute Intracerebral Hemorrhage

Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of In-Hospital Mortality in Patients with Acute Intracerebral Hemorrhage

The effect of reparixin on survival in patients at high risk for in-hospital mortality: a meta-analysis of randomized trials

Predictive value of inflammatory indices: a prospective study in critical oncological patients

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