Prognostic value of neutrophil–lymphocyte ratio in critically ill patients with cancer: a propensity score matching study

Author(s):  
Z.-Q. Chen ◽  
X.-S. Yu ◽  
L.-J. Mao ◽  
R. Zheng ◽  
L.-L. Xue ◽  
...  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Feng Wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Zhi Yang ◽  
...  

Abstract Background Immunoinflammatory and nutritional markers, such as the peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and Onodera’s prognostic nutritional index (OPNI), have gained considerable attention and have been preliminarily revealed as prognostic markers of gastrointestinal stromal tumors (GISTs). Methods In this study, we first investigated the prognostic value of OPNI in GISTs treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, and data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan–Meier method and compared by the log-rank test. Results The patients were divided into groups treated and not treated with TKIs, and we used the propensity score matching method to homogenize their baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables. A total of 563 GISTs were initially chosen, and 280 of them were included for analysis under the inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI as an independent prognostic marker that was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 42.6; HR 0.409; P < 0.001) was associated with worse RFS. Conclusions Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated and not treated with TKIs. Higher NLR and PLR have negative effects on RFS.


2021 ◽  
Author(s):  
Khalid Al Sulaiman ◽  
Ohoud Al Juhani ◽  
Hisham A. Badreldin ◽  
Khalid Bin Salah ◽  
Abdullah Al Harthi ◽  
...  

Abstract Background: Due to its supposed clinical efficacy, relative safety, and low cost, ascorbic acid represents an appealing option for clinicians to utilize in the context of a global health pandemic of COVID-19 patients.Objectives: The aim of this study was to evaluate the efficacy and safety of using ascorbic acid as adjunctive therapy in critically ill patients with COVID-19. Methods: This was a multi-center, non-interventional, retrospective cohort study. All critically ill adult patients admitted to ICU with a confirmed COVID-19 between March 1st to December 31st, 2020 were included in the final analysis. The study was conducted at two large governmental tertiary hospitals in Saudi Arabia. The purpose was to investigate the association between clinical outcomes with ascorbic acid use as an adjunctive therapy in COVID-19 after propensity score matching using baseline severity scores, systemic use of corticosteroids and study centers. Results: A 739 patients were included in this study; 296 patients were included after propensity score matching. There was no association between the administration of ascorbic acid and in-hospital mortality nor 30-day ICU mortality (OR (95%CI): 0.77 (0.476, 1.234), p-value=0.2738 and OR (95%CI): 0.73 (0.438 ,1.204), p-value=0.215 respectively). Using ascorbic acid was associated with lower incidence of thrombosis compared with the non-ascorbic acid group (6.1% vs. 13% respectively); OR (95%CI): 0.42 (0.184, 0.937), p-value=0.0342).Conclusion: Ascorbic acid use as an adjunctive therapy in COVID19 critically ill patients was not associated with mortality benefits; but associated with lower incidence of thrombosis. Further studies are required to confirm these findings.


2020 ◽  
Author(s):  
Feng Wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Xuefeng Xia ◽  
...  

Abstract Background Immunoinflammatory and nutritional markers such as peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and onodera’s prognostic nutritional index (OPNI) have gained considerable attention and revealed preliminaryly as prognostic markers in gastrointestinal stromal tumor (GIST). Methods In this study, we firstly investigated the prognostic value of OPNI in GIST treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, The data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. Results These patients who were treated with TKIs and those who did not were divided into two groups, and we used propensity score matching method to make them have more unified baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables.A total of 563 GISTs were initially chosen and 280 of them were included for analysis under an inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI was an independent prognostic marker, and was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 44.05; HR 0.433; 95% CI 0.236–0.794; P = 0.007) were associated with worse RFS. Conclusions Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated with or without TKIs.


2020 ◽  
Author(s):  
Feng Wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Zhi Yang ◽  
...  

Abstract Background Immunoinflammatory and nutritional markers such as peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and onodera’s prognostic nutritional index (OPNI) have gained considerable attention and revealed preliminaryly as prognostic markers in gastrointestinal stromal tumor (GIST). Methods In this study, we firstly investigated the prognostic value of OPNI in GIST treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, the data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. Results These patients who were treated with TKIs and those who did not were divided into two groups, and we used propensity score matching method to make them have more unified baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables. A total of 563 GISTs were initially chosen and 280 of them were included for analysis under an inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI was an independent prognostic marker, and was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 42.6; HR 0.315; P༜0.001) were associated with worse RFS. Conclusions Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated with or without TKIs.


2021 ◽  
Author(s):  
Khalid Al Sulaiman ◽  
Ohoud Al Juhani ◽  
Abdulrahman I Al Shaya ◽  
Abdullah Kharbosh ◽  
Raed Kensara ◽  
...  

Abstract Background: Zinc is a trace element that plays a role in stimulating innate and acquired immunity. The role of zinc in critically ill patients with COVID-19 remains unclear. This study aims to evaluate the efficacy and safety of zinc sulfate as adjunctive therapy in critically ill patients with COVID-19.Methods: Patients aged ≥ 18 years with a COVID-19 who were admitted to the intensive care unit (ICU) in two tertiary hospitals in Saudi Arabia were retrospectively assessed for zinc use, from 01 March 2020 until 31-December 2020. We assessed the association of zinc use as adjunctive therapy with the in-hospital and 30-day mortality after propensity score matching. Secondary outcomes included mechanical ventilation (MV) duration, ICU length of stay (LOS), hospital LOS, and complication (s) during ICU stay. Results: A total of 266 patients were included in this study after using propensity score matching. Zinc sulfate as adjunctive therapy during ICU stay was not associated with statistically significant reduction in 30-day mortality nor in-hospital mortality compared to those who did not receive zinc (HR= 0.65 CI = 0.41,1.01; p= 0.05 and HR= 0.67 CI = 0.45,1.00; p= 0.05; respectively). Moreover, MV duration (Beta coefficient 0.10 CI = -0.19,0.39; p= 0.48), ICU LOS (Beta coefficient 0.19 CI = -0.02,0.40; p=0.08) and hospital LOS (Beta coefficient 0.15 CI = -0.02,0.32; p=0.08) were not statistically significant between the two groups. Patients who received zinc have a higher odds of acute kidney injury (AKI) during ICU stay (OR= 1.80 CI = 1.08-3.0; p= 0.02). Conclusion: Zinc sulfate as adjunctive therapy in critically ill patients with COVID-19 may have survival benefit; however, was not statistically significant. Zinc use was linked with an increased risk of AKI development during ICU stay.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sung Yeon Ham ◽  
Hei Jin Yoon ◽  
Sang Beom Nam ◽  
Byung Hwan Yun ◽  
Darhae Eum ◽  
...  

AbstractSeveral studies have reported that the neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) are associated with poor prognosis. This study investigated whether NLR and/or the MPV/platelet ratio could function as predictive markers of mortality in critically ill patients. We retrospectively reviewed 1,154 patients admitted to the intensive care unit (ICU) between January 2017 and December 2017. Patients were divided into 2 groups according to 1-year mortality. We compared the NLR and MPV/platelet ratio on each day of ICU admission. Patients were classified into tertiles based on their NLR and MPV/platelet ratios, and the incidence of 1-year mortality was compared. Kaplan–Meier survival curves were plotted to evaluate their potential as prognostic factors for 1-year mortality. The NLR and MPV/platelet ratio were higher in the non-survivor group than in the survivor group. The incidence of 1-year mortality was the highest in the third tertile for both the NLR and MPV/platelet ratio. The MPV/platelet ratio was an independent predictor for 1-year mortality based on the Kaplan–Meier survival analysis. Our data showed that the MPV/platelet ratio is a predictive factor for 1-year mortality in critically ill patients.


2014 ◽  
Vol 32 (12) ◽  
pp. 1476-1480 ◽  
Author(s):  
Nazire Belgin Akilli ◽  
Mehmet Yortanlı ◽  
Hüseyin Mutlu ◽  
Yahya Kemal Günaydın ◽  
Ramazan Koylu ◽  
...  

2021 ◽  
Author(s):  
Feng Wang ◽  
Tingting Tao ◽  
Heng Yu ◽  
Yingying Xu ◽  
Zhi Yang ◽  
...  

Abstract Background Immunoinflammatory and nutritional markers such as peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and onodera’s prognostic nutritional index (OPNI) have gained considerable attention and revealed preliminaryly as prognostic markers in gastrointestinal stromal tumor (GIST). Methods In this study, we firstly investigated the prognostic value of OPNI in GIST treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, the data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test. Results These patients who were treated with TKIs and those who did not were divided into two groups, and we used propensity score matching method to make them have more unified baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables. A total of 563 GISTs were initially chosen and 280 of them were included for analysis under an inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI was an independent prognostic marker, and was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 42.6; HR 0.315; P༜0.001) were associated with worse RFS. Conclusions Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated with or without TKIs.


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