Neutrophil-to-Lymphocyte Ratio Associates Independently With Mortality in Hospitalized Patients With Cirrhosis

Objective: To examine any prospective association between neutrophil-to-lymphocyte ratio (NLR) at hospital admission and subsequent delirium in older COVID-19 hospitalized patients comparing by sex and age groups.Methods: The sample consisted of 1,785 COVID-19 adult inpatients (minimum sample size required of 635 participants) admitted to a public general hospital in Madrid (Spain) between March 16th and April 15th, 2020. Variables were obtained from electronic health records. Binary logistic regression models were performed between baseline NLR and delirium adjusting for age, sex, medical comorbidity, current illness severity, serious mental illness history and use of chloroquine and dexamethasone. An NLR cut-off was identified, and stratified analyses were performed by age and sex. Also, another biomarker was tested as an exposure (the systemic immune-inflammation index –SII).Results: 55.3% of the patients were men, with a mean age of 66.8 years. Roughly 13% of the patients had delirium during hospitalization. NLR on admission predicted subsequent delirium development (adjusted OR = 1.02, 95 percent CI: 1.00–1.04, p = 0.024). Patients between 69 and 80 years with NLR values > 6.3 presented a twofold increased risk for delirium (p = 0.004). There were no sex differences in the association between baseline NLR and delirium (p > 0.05) nor SII predicted delirium development (p = 0.341).Conclusion: NLR is a good predictor of delirium during hospitalization, especially among older adults, independently of medical comorbidity, illness severity, and other covariates. Routine blood tests on admission might provide valuable information to guide the decision-making process to be followed with these especially vulnerable patients.

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THE PREDICTORS OF HOSPITALIZATION IN HEMODIALYSIS PATIENTS

Ukrainian Journal of Nephrology and Dialysis ◽

10.31450/ukrjnd.2(42).2014.07 ◽

2014 ◽

pp. 35-38

Author(s):

I. Dudar ◽

Y. Gonchar ◽

V. Savchuk

Keyword(s):

Risk Factors ◽

Lymphocyte Count ◽

Absolute Lymphocyte Count ◽

Hemodialysis Patients ◽

Hospitalized Patients ◽

Neutrophil To Lymphocyte Ratio ◽

Plasma Albumin ◽

Lymphocyte Ratio ◽

Hemoglobin Variability ◽

Hb Concentration

Summary. The aim of the present research was to identify predictors of hospitalization hemodialysis (HD) patients. Materials and methods. The study involved 186 HD patients (49,38±0,94 у.) between Jan 2013 and Jan 2014. We studied the evolution of laboratory and treatment parameters, including dry body-weight, ultrafiltration, mean blood pressure, plasma albumin, Hb, absolute lymphocyte count, absolute neutrophil count, neutrophil-to-lymphocyte ratio, “hemoglobin variability ” all patients. The HD patients were divided for 2 groups: I group of outpatients (n=103), II group of hospitalized patients (n=83). Data from 83 hospitalized patients were compared with non-hospitalized patients. Laboratory and treatment parameters were assessed at least 3 months prior to admission. Results. We found that hospitalization was 45,29±4,20 days, frequency of hospitalization 1,46±0,07. The likelihood of frequency and duration a hospitalization increased with patient age (p<0,05). Hospitalizations were preceded by a decrease level albumin, a decline in Hb concentration, a decrease absolute lymphocyte count, increase in the neutrophil-to-lymphocyte ratio, a reduction ultrafiltration. The hozpitalization of patients with “stable hemoglobin ” was significantly lower than in patients with “low of hemoglobin variability”(p<0,005). Conclusions. Patients whose noted these parameters should be monitored, thus, it may be useful to identify risk factors for hospitalization.

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Prognostic value of neutrophil-to-lymphocyte ratio in hospitalized patients with COVID-19

10.1183/13993003.congress-2021.pa3489 ◽

2021 ◽

Author(s):

Nouha Boubaker ◽

Besma Hamdi ◽

Sabrine Louhaichi ◽

Ikbel Khalfallah ◽

Mariem Ferchichi ◽

...

Keyword(s):

Prognostic Value ◽

Hospitalized Patients ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio

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Faculty Opinions recommendation of Neutrophil to Lymphocyte Ratio Associates Independently With Mortality in Hospitalized Patients with Cirrhosis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.733133157.793555641 ◽

2019 ◽

Author(s):

Tilman Sauerbruch

Keyword(s):

Hospitalized Patients ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio

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Correlation of Low Levels of α-1 Antitrypsin and Elevation of Neutrophil to Lymphocyte Ratio with Higher Mortality in Severe COVID-19 Patients

Mediators of Inflammation ◽

10.1155/2021/5555619 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Ghazaleh Shimi ◽

Golbon Sohrab ◽

Katayoun Pourvali ◽

Arman Ghorbani ◽

Farinaz Hosseini Balam ◽

...

Keyword(s):

Immune Response ◽

Mortality Rate ◽

Blood Sugar ◽

Arterial Oxygen Saturation ◽

Hospitalized Patients ◽

Neutrophil To Lymphocyte Ratio ◽

Arterial Oxygen ◽

Lymphocyte Ratio ◽

Serum Glutamate ◽

Low Serum

Background. Variations in COVID-19 prevalence, severity, and mortality rate remain ambiguous. Genetic or individual differences in immune response may be an explanation. Moreover, hyperinflammation and dysregulated immune response are involved in the etiology of severe forms of COVID-19. Therefore, the aim of the present study was to analyze serum alpha-1 antitrypsin (AAT) levels, as an acute-phase plasma protein with immunomodulatory effect and neutrophil to lymphocyte ratio (NLR) as a marker of inflammation response in severe COVID-19 illness. Methods. In this retrospective observational cohort study, 64 polymerase chain reaction (PCR) positive COVID-19 hospitalized patients were studied for AAT, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), troponin, complete blood count (CBC), random blood sugar, serum glutamate oxaloacetate transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), and arterial oxygen saturation (O2sat) at admission and during hospitalization. Results. The results showed that hospitalized patients with COVID-19 had low serum levels of AAT and high CRP levels at the first days of hospitalization. In particular, the percentages of individuals with low, normal, and high AAT levels were 7.80%, 82.80%, and 9.40%, respectively, while high and low values of CRP accounted for 86.70% and 13.30% of patients. Most of the patients had an upward neutrophil to lymphocyte ratio (NLR) trend, with a higher mortality rate ( p < 0.05 ) and troponin levels ( p < 0.05 ). However, comorbidities, CRP alterations, ESR alterations, nonfasting blood sugar, SGOT, SGPT, O2sat, RBC, and PLT values were not significantly different between the NLR downward and upward trend groups. Conclusions. The current study revealed that severe COVID-19 patients had low serum AAT levels related to CRP values. Therefore, AAT response may be considered as a new mechanism by which some COVID-19 patients show immune dysregulation and more severe symptoms.

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