MO379EVALUATION OF NEUTROPHIL-LYMPHOCYTE RATIO IN PROGNOSIS OF SEVERE ACUTE RENAL INJURY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Lei Chen ◽  
Limin Wei
Keyword(s):  
Logistic Regression ◽  
Inflammatory Response ◽  
Critically Ill ◽  
Sofa Score ◽  
Critically Ill Patients ◽  
Predictive Value ◽  
Binary Logistic Regression ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Prognosis Evaluation

Abstract Background and Aims Recently, more and more attention has been paid to the predictive value of neutrophil to lymphocyte ratio (NLR) in various diseases. As a novel marker for inflammatory response, NLR has been proved to be useful for the diagnosis and prognosis evaluation of inflammatory diseases such as tumor, diabetes, atherosclerosis and other disease. It is well known that inflammatory response plays an important role in the occurrence and development of AKI. Previous studies have shown that NLR has a great value in the diagnosis of AKI, but its value in the prognosis evaluation in AKI patients, especially in critical ill patients with AKI, remains unclear. This study aimed at investigating the predictive value of neutrophil-lymphocyte ratio (NLR) on the risk of 90-day mortality in critically ill patients with acute kidney injury (AKI), so as to provide a simple, feasible, and valuable tool for the prognosis assessment of such patients. Method The data of 802 critically ill patients with AKI admitted to the intensive care unit of the First Affiliated Hospital of Xi'an Jiaotong University from January 2015 to December 2019 were retrospectively analyzed. According to the initial NLR level at admission, they were divided into a low NLR group (NLR≤9) and a high NLR group (NLR>9). Differences in comorbidities, the initial Sequential Organ Failure Assessment (SOFA) score, white blood cell (WBC), neutrophil percentage (Neu%), hemoglobin (Hb), platelet (PLT), lactic acid (Lac), pH, blood glucose (Glu), creatine kinase (CK), and all-cause mortality at 90-day were compared between groups. Binary Logistic regression model was used to analyze the risk factors for 90-day mortality in critically ill patients with AKI, and the receiver operating characteristic (ROC) curve was computed to evaluate the predictive value of NLR for the risk of 90-day mortality in such patients. Results There were no statistically significant differences in age, sex, and Glu between the two groups. The SOFA score, WBC, Hb, Plt, Lac, CK, SC, BUN and NEU％of patients in the high NLR group were higher than those in the low NLR group, while the BMI and pH value was lower in the high NLR group than that in the low NLR group. The 90-day mortality rate was significantly higher in the high NLR group than that in the low NLR group (36.2% vs 16%, P < 0.001). Binary Logistic regression showed that NLR was an independent risk factor for 90-day mortality in critically ill patients with AKI (OR＝2.402, 95% CI:1.633-3.533,ï¼°＜0.001), even after adjusting for age, gender, BMI, comorbidities, SOFA score, and AKI stages. The area under the ROC curve (AUC) of NLR predicting 90-day mortality was 0.613 with a highest prognostic cut-off point of 8. The sensitivity was 65.77%, and the specificity was 54.78%. Conclusion NLR has a predictive value on risk of the 90-day mortality in critically ill patients with AKI. As a simple and easily available clinical indicator, NLR could be applied as a valuable tool in guiding the initial treatment of such patients.

Diagnostic and prognostic value of presepsin vs. established biomarkers in critically ill patients with sepsis or systemic inflammatory response syndrome

2018 ◽  
Vol 56 (4) ◽  
pp. 658-668 ◽  
Author(s):  
Helena Brodska ◽  
Jiri Valenta ◽  
Kveta Pelinkova ◽  
Zdenek Stach ◽  
Robert Sachl ◽  
...  
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Critically Ill ◽  
Sofa Score ◽  
Critically Ill Patients ◽  
Severity Of Illness ◽  
Systemic Inflammatory Response ◽  
Reactive Protein ◽  
Failure Assessment ◽  
Clinical Illness

Abstract Background: Inflammatory biomarkers may aid to distinguish between systemic inflammatory response syndrome (SIRS) vs. sepsis. We tested the hypotheses that (1) presepsin, a novel biomarker, can distinguish between SIRS and sepsis, and (2) higher presepsin levels will be associated with increased severity of illness and (3) with 28-day mortality, outperforming traditional biomarkers. Methods: Procalcitonin (PCT), C-reactive protein (CRP), presepsin, and lactate were analyzed in 60 consecutive patients (sepsis and SIRS, n=30 per group) on day 1 (D1) to D3 (onset sepsis, or after cardiac surgery). The systemic organ failure assessment (SOFA) score was determined daily. Results: There was no difference in mortality in sepsis vs. SIRS (12/30 vs. 8/30). Patients with sepsis had higher SOFA score vs. patients with SIRS (11±4 vs. 8±5; p=0.023), higher presepsin (AUC=0.674; p<0.021), PCT (AUC=0.791; p<0.001), CRP (AUC=0.903; p<0.0001), but not lactate (AUC=0.506; p=0.941). Unlike other biomarkers, presepsin did not correlate with SOFA on D1. All biomarkers were associated with mortality on D1: presepsin (AUC=0.734; p=0.0006; best cutoff=1843 pg/mL), PCT (AUC=0.844; p<0.0001), CRP (AUC=0.701; p=0.0048), and lactate (AUC=0.778; p<0.0001). Multiple regression analyses showed independent associations of CRP with diagnosis of sepsis, and CRP and lactate with mortality. Increased neutrophils (p=0.002) and decreased lymphocytes (p=0.007) and monocytes (p=0.046) were also associated with mortality. Conclusions: Presepsin did not outperform traditional sepsis biomarkers in diagnosing sepsis from SIRS and in prognostication of mortality in critically ill patients. Presepsin may have a limited adjunct value for both diagnosis and an early risk stratification, performing independently of clinical illness severity.

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

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sung Yeon Ham ◽  
Hei Jin Yoon ◽  
Sang Beom Nam ◽  
Byung Hwan Yun ◽  
Darhae Eum ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Mean Platelet Volume ◽  
Independent Predictor ◽  
Platelet Volume ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
The Third ◽  
Survivor Group ◽  
Kaplan Meier

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.

Prognostic importance of neutrophil-lymphocyte ratio in critically ill patients: short- and long-term outcomes

2014 ◽  
Vol 32 (12) ◽  
pp. 1476-1480 ◽  
Author(s):  
Nazire Belgin Akilli ◽  
Mehmet Yortanlı ◽  
Hüseyin Mutlu ◽  
Yahya Kemal Günaydın ◽  
Ramazan Koylu ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Long Term Outcomes ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Short And Long Term ◽  
Prognostic Importance

Prognostic Value of Lactate / Albumin Ratio combined with APACHE II, SAPS II and SOFA Score for Predicting Mortality in Critically Ill Patients with Septic Shock

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Walid H Nofal ◽  
Sahar K Abo Alela ◽  
Moustafa M Aldeeb ◽  
Gamal M Elewa
Keyword(s):  
Septic Shock ◽  
Critically Ill ◽  
Sofa Score ◽  
Critically Ill Patients ◽  
Predictive Value ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Albumin Ratio ◽  
Saps Ii ◽  
Saps Ii Score

Abstract Background Despite all worldwide efforts towards sepsis, more than 5.3 million patients die annually. Till now, there is no parameter or score to detect mortality in septic patients precisely. Objectives The aim of this study was to evaluate the prognostic performance of the lactate/albumin (L/A) ratio when combined with APACHE II score, SOFA score and SAPS II for predicting 28-day mortality in critically ill patients with septic shock. Patients and Methods After approval of the Medical Ethics Committee of Ain Shams Faculty of Medicine, an informed consent was taken from the patient or next of kin to include his/her data in this study. All patients who were admitted to the intensive care units (ICUs) with septic shock from 1st of September, 2019 to 30th of March, 2020 were assessed for enrollment in this study. Results In this prospective observational study, 100 adult patients of both sexes with septic shock were enrolled. They were categorized into two groups according to the primary endpoint (outcome) “28-days mortality”. Sixty-one patients (61%) died (non-survivors’ group) and thirtynine patients (39%) survived (survivors group). The most significant factors which affecting the mortality were LAR, SOFA score on admission, APACHE II, and SAPS II score. Prediction performance of the four variables for estimating 28 days mortality. When combined LAR + SOFA, LAR + APACHE, LAR + SAPS II, Overall score the ROC (AUROC, 0.867,0.847,0.849,,0.899 respectively) was the highest, compared to the other single models and lower cutoff (&gt;0.48, &gt;0.53, &gt;0.42, &gt;0.47 respectively)in comparison to single scores. Moreover, the overall score (including the 4 parameters together) gave the best predictive value for 28 day mortality Conclusion Lactate/Albumin ratio combined with APACHI II, SOFA and SAPS scores gave the best predictive value for 28 day mortality in septic shock patients, when compared with each separate score Recommendations combined LAR + SOFA, LAR + APACHE, LAR + SAPS II, Overall score recommended to use to predictho spital mortality, Further research on large sample sizeto study the risk stratification and implementing new scores using the lactate/albumin ratio (LAR) is needed. Simple, available and cheap markers should be used in developing new prediction scores.

Inflammatory biomarkers as pronostic factors of mortality in critical ILL oncology patients at ICU.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14535-e14535
Author(s):  
Carlos Aliaga Macha ◽  
Thanya Runciman ◽  
Carlos F. Carracedo
Keyword(s):  
Prognostic Factors ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Inflammatory Markers ◽  
Area Under The Curve ◽  
Roc Curves ◽  
P Value ◽  
Predictive Values ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

e14535 Background: Inflammatory markers have been used as prognostic factors in multiple malignancies.In cancer patients, critically ill, the utility of these have limited data.The aim of our study is to determine whether neutrophil lymphocyte ratio (NLR) or lymphocyte platelet ratio(PLR) are prognostic factors for mortality in critically ill patients. Methods: We retrospectively analyzed data of 79 patients with solid tumors admitted to ICU at Sanna-Aliada Clinic between January 2018 to December 2018. Inflammatory markers results were obtained from laboratory tests performed during the first 24h of admission to ICU. Receiving operating characteristic (ROC) curves were constructed and the sensitivity, specificity, predictive values and probability indicators for the NLR and PLR. Results: A total of 79 patients were assessed, 39 women and 40 men. The average age was 60.28 years, median of 61 ( 18 to 91). 51.9% had metastatic disease. The most frequent places were lung 12 (15.2 %) and brain 9 (11,4%) . The main cause for admission to ICU was infectious disease (40.5%). The analysis of normality (Kolmogorov-Smirnov test) indicates that the variables age, hemoglobin, leukocytes, platelets, neutrophils, lymphocytes, have a normal deviation while the other variables: lactate, PCR, neutrophil to lymphocyte ratio (NLR) , Platelet to lymphocyte ratio (PLR) are not distributed normally. Regarding mortality, 44 patients were alive at 30 days (66.7%), and 30 (45.5%) were alive at 90 days. The average stay in the ICU was 8.43 days, with a median of 6, (SD 7.17, 1 to 40 days), 22.8% died in the ICU. The evaluation of PLR and NLR as a mortality marker is significant for the group of patients admitted to the ICU due to a noninfectious pathology, generating an area under the curve (AUC) of 0.706 for NLR (95% CI, 0.535 - 0.876, p-value = 0.035) and 0.767 for PLR (95% CI, 0.615-0.918; p-value = 0.006); the optimal cut point by Youden’s index for NLR was 8.29 and 267.94 for PLR (Sensitivity: 76%, Specificity: 67%). In contrast, the group with infectious pathology, the AUC was 0.47 for NLR (p = 0.78) and 0.42 for PLR (p = 0.44). The relationship of the biomarkers with stay in ICU was also evaluated, finding a statistically significant association with the lactate value (p = 0.024, Kruskal-Wallis) Conclusions: Inflammatory markers are useful as predictive markers of mortality in critically ill patients due to non-infectious causes. The lactate value serves as a predictive factor of stay in the ICU for all the patients. We suggest carrying out prospective studies to confirm the validity of our findings.

scholarly journals Can Preoperative Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio Predict Systemic Inflammatory Response Syndrome That Develops After Percutaneous Nephrolithotomy?

2021 ◽  
Author(s):  
Uygar Miçooğulları ◽  
Orçun Çelik ◽  
Mehmet Çağlar Çakıcı ◽  
Erdem Kısa ◽  
Cem Yücel ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Percutaneous Nephrolithotomy ◽  
Systemic Inflammatory Response ◽  
Blood Transfusions ◽  
Multivariate Logistic Regression ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio

Objective: First objective of this study was to find out factors influencing development of postoperative systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PNL). Secondary objective was to point out the role of preoperative neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in SIRS estimation. Method: The data of 756 patients that underwent PNL for kidney stones between 2012 and 2019 were evaluated retrospectively. Patients were divided into 2 groups as non-SIRS and SIRS group. The effects of NLR, PLR and other operative and demographic variables on development of SIRS were investigated. Multivariate logistic regression analysis that was performed on variables that were significant in the univariate analyses was used to establish independent risk factor for post-PNL SIRS. Results: Univariate analysis revealed a significant association between presence of SIRS and preoperative PLR (p<0.001), preoperative NLR (p<0.001), blood transfusion (p<0.001), stone volume (p=0.03), staghorn stone (p<0.001), and preoperative creatinine levels (<0.001). Multivariate logistic regression analyses of these risk factors showed that NLR (p<0.001), PLR (p<0.001), and blood transfusions (p<0.001) were independently associated with SIRS. When the cut-off value of PLR was 120.5, the development of SIRS was predicted with 80.1% specificity and 81% sensitivity. When the cut-off value of NLR was 2.75, the development of SIRS was predicted with 64% specificity and 63.7% sensitivity. Conclusion: Preoperative PLR and NLR are effective and inexpensive biomarkers that can be used to predict SIRS and sepsis after PNL. We recommend that patients with PLR >120.5, NLR >2.75, and blood transfusions should be monitored closely due to the possible development of serious complications.

scholarly journals High Neutrophil-lymphocyte Ratio Is a Prognostic Marker for Mortality in Severe Covid-19 and Is Associated With Elevated Age and Kidney Failure

2021 ◽  
Author(s):  
Heitor Santos ◽  
Felipe Delpino ◽  
Octavio Veloso ◽  
Juliana Freire ◽  
Erlaine Gomes ◽  
...  
Keyword(s):  
Critically Ill ◽  
Prognostic Marker ◽  
Kidney Failure ◽  
Critically Ill Patients ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Crude Model ◽  
Obesity Hypertension

Abstract Neutrophil and lymphocyte ratio (NLR) has emerged as a prognostic marker in intensive care. This study aimed to associate high NLR values with COVID-19-associated diseases and mortality among critically ill patients. A cross-sectional study encompassing 189 critically ill patients with COVID-19 was performed. Crude model and adjusted (1- age; 2- sex; 3- kidney failure, diabetes, obesity, hypertension, sex, and age) modes were used. Participants with NLR ≥10.6 were older than those with NLR <10.6 (p < 0.001). The number of deaths (37 vs. 18, p = 0.001) and patients with kidney failure (30 vs. 20, p = 0.045) were higher for NLR ≥10.6 than NLR <10.6. NLR ≥10.6 was associated with higher number of deaths for the crude model (OR: 3.10 [95%CI:1.60-6.01], p = 0.001), age-adjusted (OR: 2.62 [95%CI:1.32-5.20], p = 0.006) and sex-adjusted (OR: 2.97 [95%CI:1.52-5.78], p = 0.031), as well as in the fully-adjusted model (OR: 2.48 [95%CI:1.21-5.08], p = 0.013), when compared to NLR <10.6. Older adults (≥60y) had an OR of 2.61 (95%CI:1.26-5.39, p = 0.010) for mortality compared to adults (≤59y), and the same value was found for the model adjusted for sex (OR: 2.61 [95%CI:1.26-5.42], p = 0.010). Kidney failure was associated with mortality for the crude model (OR: 2.58 [95%CI:1.30-5.11], p = 0.007), age-adjusted (OR: 2.09 [95%CI:1.02-4.27], p = 0.044), and sex-adjusted (OR: 2.45 [95%CI:1.23-4.89], p = 0.011). In conclusion, high NLR is a prognostic marker for mortality in severe COVID-19 and is associated with advanced age and kidney failure.

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