The Effectiveness of Neutrophil-Lymphocyte Ratio in Predicting in-Hospital Mortality in Non-ST-Elevation Myocardial Infarction

Background. Myocardial infarction is the most common cause of death all over the world. There are many studies in predicting mortality. The aim of this study was to determine the effectiveness of hematologic parameters measured at the moment of admission to the emergency room in predicting in-hospital mortality and to determine cutoff values of strongly predictive values. Methods. A total of 681 patients over 18 years of age, whose date could be obtained, were included in the study. From the hemogram parameters, white blood cells (WBC), red cell distribution width (RDW), mean platelet volume (MPV), and neutrophils-to-lymphocytes ratio (NLR) values were determined and recorded. CK-MB and high-sensitive troponin T values were recorded as cardiac markers. For statistical analysis, “SPSS for Windows version 21” package program was used. Results. 62.6% (n = 426) of the patients were male, and 37.4% (n = 255) of the patients were female. The NLR was found to be the strongest predictor (area under the curve (AUC), 0.783, SD = 0.052, 95% confidence interval (CI)). It was found that the WBC value came in the second place after NLR as a strong predictor of mortality (AUC, 0.702, SD = 0.075, 95% CI). Conclusion. According to the hemogram results which were acquired with a simple and cheap method, we found that WBC and especially NLR values obtained with a simple method can be used as powerful predictors.

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Value of Hematological and Coagulation Parameters as Prognostic Factors in Acute Coronary Syndromes

Diagnostics ◽

10.3390/diagnostics11050850 ◽

2021 ◽

Vol 11 (5) ◽

pp. 850

Author(s):

Elena Emilia Babes ◽

Dana Carmen Zaha ◽

Delia Mirela Tit ◽

Aurelia Cristina Nechifor ◽

Simona Bungau ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Hospital Mortality ◽

Acute Coronary Syndromes ◽

White Blood Cells ◽

St Elevation Myocardial Infarction ◽

Distribution Width ◽

Coagulation Parameters ◽

Coronary Syndromes ◽

St Elevation

The values of hematological and coagulation biomarkers were evaluated as predictors of in hospital mortality and complications, in patients with acute coronary syndromes (ACS). This retrospective observational study enrolled 936 ACS subjects admitted to the Clinical Emergency Hospital of Oradea, Romania, between January–December 2019. Hematological and coagulation parameters were obtained at admission. During hospitalization, the following adverse events were recorded: death, ventricular rhythm disturbances, atrial fibrillation, heart failure, re-infarction, and stroke. Accuracy of hematological and coagulation parameters as predictors of adverse outcome were also evaluated. The diagnosis was unstable angina in 442 patients (47.22%), non-ST-elevation myocardial infarction (NSTEMI) in 113 patients (12.1%) and ST-elevation myocardial infarction (STEMI) in 381 patients (40.70%); 87 patients (9.29%) died during hospitalization and 193 (20.7%) developed complications. Predictors for in hospital mortality were as follows: red cell distribution width (RDW) (AUC 0.691, p < 0.0001), white blood cells (WBC) (AUC 0.684, p < 0.0001), neutrophils (NEU) (AUC 0.684, p < 0.0001), and prothrombin time (PT) (AUC 0.765, p < 0.0001). WBC (AUC 0.659, p < 0.0001), NEU (AUC 0.664, p < 0.0001), RDW (AUC 0.669, p < 0.0001), and PT (AUC 0.669, 95% CI 0.622–0.714, p < 0.0001) also had accuracy for complications prediction. RDW had a good ability to predict heart failure in NSTEMI patients (AUC 0.832, p < 0.0001). An acceptable ability to predict ventricular rhythm disturbances occurrence had WBC (AUC 0.758, p < 0.0001) and NEU (AUC 0.772, p < 0.0001). Hematological and coagulation parameters can help in risk stratification of ACS patients. RDW, WBC, NEU, and PT were able to predict mortality and in-hospital complications in ACS patients. RDW has a good accuracy in predicting complications and heart failure in NSTEMI patients. WBC and NEU are good predictors for ventricular rhythm disturbances.

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Study of the sensitivity and specificity of smell and taste disorders as a predictive factor of SARS-CoV-2 infection among primary care healthcare professionals

BJGP Open ◽

10.3399/bjgpo.2021.0141 ◽

2022 ◽

pp. BJGPO.2021.0141

Author(s):

Anna Ruiz-Comellas ◽

Pere Roura Poch ◽

Glòria Sauch Valmaña ◽

Víctor Guadalupe-Fernández ◽

Jacobo Mendioroz Peña ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Clinical Symptoms ◽

Strong Predictor ◽

Area Under The Curve ◽

Low Grade ◽

Predictive Values ◽

Standard Value ◽

Taste Disorders ◽

Smell Disorders ◽

Taste And Smell

Backgroundamong the manifestations of COVID-19 are Taste and Smell Disorders (TSDs).AimThe aim of the study is to evaluate the sensitivity and specificity of TSDs and other associated symptoms to estimate predictive values for determining SARS-CoV-2 infection.Design and settingRetrospective observational study.Methodsa study of the sensitivity and specificity of TSDs has been carried out using the Polymerase Chain Reaction (PCR) test for the diagnosis of SARS-CoV-2 as the Gold Standard value. Logistic regressions adjusted for age and sex were performed to identify additional symptoms that might be associated with COVID-19.Resultsthe results are based on 226 healthcare workers with clinical symptoms suggestive of COVID-19, 116 with positive PCR and 111 with negative PCR. TSDs had an OR of 12.43 (CI 0.95 6.33–26.19), sensitivity 60.34% and specificity 89.09%. In the logistic regression model, the association of TSD, fever or low-grade fever, shivering, dyspnoea, arthralgia and myalgia obtained an area under the curve of 85.7% (CI 0.95: 80.7 % - 90.7 %), sensitivity 82.8 %, specificity 80% and positive predictive values 81.4% and negative 81.5%.ConclusionsTSDs are a strong predictor of COVID-19. The association of TSD, fever, low-grade fever or shivering, dyspnoea, arthralgia and myalgia correctly predicts 85.7% of the results of the COVID-19 test.

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Novel predictor of the occurrence of DKA in T1DM patients without infection: A combination of neutrophil/lymphocyte ratio and white blood cells

Open Life Sciences ◽

10.1515/biol-2021-0141 ◽

2021 ◽

Vol 16 (1) ◽

pp. 1365-1376

Author(s):

Yiping Cheng ◽

Wenhao Yu ◽

Yuping Zhou ◽

Tao Zhang ◽

Haiyan Chi ◽

...

Keyword(s):

Blood Cells ◽

Low Cost ◽

Characteristic Curve ◽

White Blood Cells ◽

Area Under The Curve ◽

Control Group ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio

Abstract The role of inflammation has been identified in the pathogenesis of diabetic ketoacidosis (DKA). The neutrophil/lymphocyte ratio (NLR) and white blood cells (WBC) can be used to predict a systemic inflammatory response. Changes in NLR and WBC levels have never been explored in type 1 diabetes mellitus (T1DM) patients with DKA and an uninfected state. This retrospective study included a total of 644 participants. NLR and WBC were measured in the control group (n = 316) and in T1DM patients with mild-DKA (n = 92), severe-DKA (n = 52), and non-DKA (n = 184) in an uninfected state. Then, we assessed the independent predictors of DKA occurrence in T1DM patients in an uninfected state. The diagnostic performance of variables was determined by receiver operating characteristic curve analysis. Serum NLR of T1DM patients is significantly higher than that of normal controls, and if DKA occurs, NLR increases further and increases with the severity of DKA. In addition to diastolic blood pressure, blood urea nitrogen, glycated hemoglobin (HbA1c), and WBC, NLR was also independently associated with DKA in T1DM patients with an uninfected state (OR = 1.386, 95% CI: 1.127–1.705, p = 0.002). Furthermore, the diagnosis analysis showed that except for NLR and WBC, the area under the curve (AUC) of indicators with a statistical difference in patients with and without DKA were 0.747 for DKA diagnosis, and after the addition of NLR and WBC, the AUC was 0.806. The increased NLR level represents a low-cost and highly accessible predictor for DKA in T1DM patients with an uninfected state. The addition of inflammation indicators can play a statistically significant role in the prediction model of the DKA occurrence.

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BNP and Admission Glucose as In-Hospital Mortality Predictors in Non-ST Elevation Myocardial Infarction

The Scientific World JOURNAL ◽

10.1100/2012/397915 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Julio Yoshio Takada ◽

Rogério Bicudo Ramos ◽

Solange Desiree Avakian ◽

Soane Mota dos Santos ◽

José Antonio Franchini Ramires ◽

...

Keyword(s):

Myocardial Infarction ◽

Hospital Mortality ◽

Predictive Value ◽

Area Under The Curve ◽

St Elevation Myocardial Infarction ◽

Hospital Death ◽

Coronary Syndromes ◽

St Elevation ◽

Independent Risk Factors

Objectives. Admission hyperglycemia and B-type natriuretic peptide (BNP) are associated with mortality in acute coronary syndromes, but no study compares their prediction in-hospital death.Methods. Patients with non-ST-elevation myocardial infarction (NSTEMI), in-hospital mortality and two-year mortality or readmission were compared for area under the curve (AUC), sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), and accuracy (ACC) of glycemia and BNP.Results. Respectively, AUC, SEN, SPE, PPV, NPV, and ACC for prediction of in-hospital mortality were 0.815, 71.4%, 84.3%, 26.3%, 97.4%, and 83.3% for glycemia = 200 mg/dL and 0.748, 71.4%, 68.5%, 15.2%, 96.8% and 68.7% for BNP = 300 pg/mL. AUC of glycemia was similar to BNP (P=0.411). In multivariate analysis we found glycemia ≥200mg/dL related to in-hospital death (P=0.004). No difference was found in two-year mortality or readmission in BNP or hyperglycemic subgroups.Conclusion. Hyperglycemia was an independent risk factor for in-hospital mortality in NSTEMI and had a good ROC curve level. Hyperglycemia and BNP, although poor in-hospital predictors of unfavorable events, were independent risk factors for death or length of stay >10 days. No relation was found between hyperglycemia or BNP and long-term events.

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Neutrophil-lymphoycyte-ratio, platelet-lymphocyte-ratio and procalcitonin for early assessment of prognosis in patients undergoing VA-ECMO

Scientific Reports ◽

10.1038/s41598-021-04519-7 ◽

2022 ◽

Vol 12 (1) ◽

Author(s):

Sebastian Roth ◽

René M’Pembele ◽

Alexandra Stroda ◽

Catrin Jansen ◽

Giovanna Lurati Buse ◽

...

Keyword(s):

Hospital Mortality ◽

Area Under The Curve ◽

Final Analysis ◽

Operating Characteristics ◽

Early Assessment ◽

Discriminative Ability ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Platelet Lymphocyte Ratio ◽

Va Ecmo

AbstractThe use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasing, but mortality remains high. Early assessment of prognosis is challenging and valid markers are lacking. This study aimed to investigate Neutrophil–Lymphocyte Ratio (NLR), Platelet-Lymphocyte-Ratio (PLR) and Procalcitonin (PCT) for early assessment of prognosis in patients undergoing VA-ECMO. This retrospective single-center cohort study included 344 consecutive patients ≥ 18 years who underwent VA-ECMO due to cardiogenic shock. Main exposures were NLR, PLR and PCT measured within 24 h after VA-ECMO initiation. The primary endpoint was all-cause in-hospital mortality. In total, 92 patients were included into final analysis (71.7% male, age 57 ± 14 years). In-hospital mortality rate was 48.9%. Receiver operating characteristics (ROC) curve revealed an area under the curve (AUC) of 0.65 [95% confidence interval (CI) 0.53–0.76] for NLR. The AUCs of PLR and PCT were 0.47 [95%CI 0.35–0.59] and 0.54 [95%CI 0.42–0.66], respectively. Binary logistic regression showed an adjusted odds ratio of 3.32 [95%CI 1.13–9.76] for NLR, 1.0 [95%CI 0.998–1.002] for PLR and 1.02 [95%CI 0.99–1.05] for PCT. NLR is independently associated with in-hospital mortality in patients undergoing VA-ECMO. However, discriminative ability is weak. PLR and PCT seem not to be suitable for this purpose.

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Prognostic Value of Red Blood Cell Distribution Width in Prediction of In-Hospital Mortality in Patients with Acute Myocardial Infarction

Clinical Laboratory ◽

10.7754/clin.lab.2013.130907 ◽

2014 ◽

Vol 60 (08/2014) ◽

Cited By ~ 6

Author(s):

Manuela Sangoi ◽

Naiara Guarda ◽

Ana Rödel ◽

Pietra Zorzo ◽

Priscila Borges ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Blood Cell ◽

Hospital Mortality ◽

Red Blood Cell ◽

Prognostic Value ◽

Cell Distribution ◽

Distribution Width ◽

Red Blood Cell Distribution

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

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e14535 ◽

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.

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