scholarly journals Identify the Early Predictor of Mortality in Patients with Acute Paraquat Poisoning

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jun Wang ◽  
Xinrui Jiang ◽  
Geng Lu ◽  
Jiawei Zhou ◽  
Jian Kang ◽  
...  

Background. Paraquat is a widely used nonselective and fast-acting contact herbicide worldwide. This study identified the early predictor of mortality in patients with acute paraquat poisoning. Methods. Twenty-nine patients with acute paraquat poisoning admitted at Nanjing Drum Tower Hospital from January 2018 to August 2020 were included in this study. The early predictor of mortality in patients with acute paraquat poisoning based on the blood tests was identified by correlation, logistic regression, and receiver operating characteristic (ROC) analyses. Result. 15 of the 29 patients died after poisoning. Compared to the survivors, the neutrophilic granulocyte ratio, leukocyte count, ALB, and Crea of the nonsurvivors were significantly higher with p value < 0.05, while the lymphocyte ratio and eGFR(MDRD) of the nonsurvivors were remarkably lower with p value < 0.01. Moreover, the neutrophil-to-lymphocyte ratio (NLR) was remarkably upregulated in the nonsurvivors. The area under the ROC curve (AUC) of the neutrophilic granulocyte ratio, lymphocyte ratio, leukocyte count, ALB, Crea, eGFR(MDRD), and NLR to predict the mortality in patients with acute paraquat poisoning was 0.8905 (95% CI: 0.7589-1.022), 0.8643 (95% CI: 0.7244-1.004), 0.8500 (95% CI: 0.7133-0.9867), 0.7286 (95% CI: 0.5338-0.9233), 0.8167 (95% CI: 0.6620-0.9713), 0.8714 (95% CI: 0.7330-1.010), and 0.8667 (95% CI: 0.7277-1.006), respectively. More interestingly, we also evaluated the diagnostic values of the different combinations of six blood test biomarkers by logistic regression analysis. According to the results of the logistic regression analysis, the AUCs for the combination of the neutrophilic granulocyte ratio, leukocyte count, and eGFR(MDRD) were the largest with 0.986 (95% CI: 0.952-1), and the sensitivity and specificity were 100% and 100%. Conclusion. This study demonstrated that the combination of the neutrophilic granulocyte ratio, leukocyte count, and eGFR(MDRD) could serve as an ideal early predictor of mortality in patients with acute paraquat poisoning. However, further research is needed to draw a clear conclusion.

2021 ◽  
Vol 16 (1) ◽  
pp. 703-710
Author(s):  
Yuhang Mu ◽  
Boqi Hu ◽  
Nan Gao ◽  
Li Pang

Abstract This study investigates the ability of blood neutrophil-to-lymphocyte ratio (NLR) to predict acute organophosphorus pesticide poisoning (AOPP). Clinical data of 385 patients with AOPP were obtained within 24 h of admission, and NLR values were calculated based on neutrophil and lymphocyte counts. The patients were divided into two groups – good and poor – based on prognosis. Poor prognosis included in-hospital death and severe poisoning. The factors affecting prognosis were analyzed by logistic regression analysis, and the prognostic value of NLR was evaluated using the area under the receiver operating characteristic curve (AUC). Univariate logistic regression analysis showed that NLR levels, serum cholinesterase, and creatinine levels were good predictors of AOPP. Multivariate logistic regression analysis showed that high NLR was an independent risk factor for severe poisoning (adjusted odds ratio [AOR], 1.13; 95% CI, 1.10–1.17; p < 0.05) and in-hospital mortality (AOR, 1.07; 95% CI, 1.03–1.11; p < 0.05). NLR values >13 and >17 had a moderate ability to predict severe poisoning and in-hospital mortality, respectively (AUC of 0.782 [95% CI, 0.74–0.824] and 0.714 [95% CI, 0.626–0.803], respectively). Our results show that high NLR at admission is an independent indicator of poor prognosis in AOPP and can be used to optimize treatment and manage patients.


Vascular ◽  
2019 ◽  
Vol 27 (6) ◽  
pp. 668-676
Author(s):  
Yihu Yi ◽  
Lingyun Zhou ◽  
Shanru Zuo ◽  
Wenjun Yin ◽  
Daiyang Li ◽  
...  

Objective Neutrophil-to-lymphocyte ratio (NLR) value has emerged as a cardiovascular prognostic marker. Although several recent studies suggested NLR was associated with arterial stiffness, it was still controversial. The aim of this study was to investigate the correlation between NLR and arterial stiffness by measuring of brachial-ankle pulse wave velocity (baPWV) in an apparently healthy population. Methods This retrospective study enrolled 5612 participants during the health examinations from 1 October 2007 to 30 September 2011. Arterial stiffness was measured by baPWV. NLR was calculated as the ratio of the absolute neutrophil count to the absolute lymphocyte count in peripheral blood. According to the quartiles of NLR, the patients were categorized into four groups in males and females, respectively. Associations between NLR and baPWV were evaluated using partial correlation and multivariate logistic regression analysis. Results Both female and male subjects with increased arterial stiffness (baPWV ≥ 1400 cm/s) were likely to be older (females: P < 0.001, males: P < 0.001) and have higher systolic blood pressure (females: P < 0.001, males: P < 0.001), diastolic blood pressure (females: P < 0.001, males: P < 0.001), fasting plasma glucose (females: P < 0.001, males: P < 0.001), serum total cholesterol (females: P < 0.001, males: P = 0.028), triglyceride (females: P < 0.001, males: P = 0.031), urea nitrogen (females: P < 0.001, males: P < 0.001) than those without increased arterial stiffness. In addition, compared to those without increased arterial stiffness, body mass index ( P < 0.001), waist circumference ( P < 0.001), low-density lipoproteins cholesterol ( P < 0.001), creatinine ( P < 0.001), uric acid ( P < 0.001) and lymphocytes ( P = 0.001) were higher in females with increased arterial stiffness. However, males with increased arterial stiffness had higher NLR value (2.0 ± 0.7 vs. 2.1 ± 0.9, P < 0.001) and neutrophils (4.3 ± 1.4 vs. 4.5 ± 1.5, P < 0.001) than those without increased arterial stiffness, while the difference was not found in females. ANCOVA showed that males with quartile 3 and quartile 4 of NLR had greater levels of baPWV. NLR was correlated to baPWV in males by partial correlation analysis (r = 0.110, P < 0.001), but not in females. In multiple logistic regression analysis, the quartile 4 of NLR was positively associated with increased arterial stiffness in males (OR = 1.43, 95% confidence intervals [CI]=1.12–1.82, P = 0.004), but there was no obvious correlation in females. Conclusions Our findings suggest that there is a gender difference in the relationship between arterial stiffness and NLR. After adjusting for other confounders, the risk of increased arterial stiffness in apparently healthy adult males (rather than females) is independently associated with the highest quartile of NLR.


2021 ◽  
Author(s):  
Xinyu Liao ◽  
Fuxing Li ◽  
Fuke Wang ◽  
Guoliang Wang ◽  
Yaxing Zheng ◽  
...  

Abstract Objective: We attempt to evaluate the role of neutrophil-to-lymphocyte ratio (NLR) in predicting 28-day mortality in patients with sepsis to investigate its prognostic value.Method: Relevant clinical and laboratory data of 91 healthy controls, 87 non-septic patients admitted to intensive care unit (ICU) and 127 septic patients on admission were collected, and septic patients were divided into survival (n=79) and death groups (n=48) according to their prognoses. NLR levels among different groups were compared and analyzed for associations with C-reactive protein (CRP), procalcitonin (PCT) and SOFA score. Univariate logistic regression analysis was used to assess the prognostic value of the NLR in patients with sepsis. Result: The NLR level was significantly higher in the septic patients compared to the case controls and healthy individuals (P < 0.05), and was much higher in septic patients who died (P < 0.05). ROC analysis indicated that the NLR had the best prognostic value for sepsis, with an AUC of 0.77 (95% CI: 0.69-0.84). Univariate logistic regression analysis suggested that NLR >8.25 was an independent risk factor for sepsis (odds ratio [OR] 6.39, P = 0.001). Correlation analysis suggested that the NLR was positively correlated with CRP, PCT and SOFA score.Conclusion: Peripheral serum NLR appeares to have a predictive value for 28-day mortality in patients with sepsis.


2020 ◽  
Author(s):  
Yiben Huang ◽  
Jianing Wang ◽  
Jiamin Shen ◽  
Keke Ding ◽  
Honghao Huang ◽  
...  

Abstract Background: Chronic obstructive pulmonary disease (COPD) has always attracted attention due to its high prevalence and high mortality. How to predict and diagnose COPD and assess the severity of the disease is our top priority. We aimed to evaluate the association between red cell index (RCI) and the severity of COPD, and compare predictive value among RCI, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) of indicating the severity of COPD.Methods: A total of 207 participants were recruited (100 COPD patients and 107 healthy controls). COPD patients were divided into two groups according to receiver operating characteristics (ROC) curves cut-off value of RCI (RCI < 1.75, n = 54; RCI > 1.75, n = 46). Pearson’s correlation test, logistic regression analysis and other tests were performed.Results: Compared with low RCI group, the forced expiration volume in 1 second (FEV1) and FEV1 in percent of the predicted value (FEV1%) of high RCI group decreased (p = 0.016, p = 0.001). There is a negative correlation between RCI and FEV1% (r = -0.302, p = 0.004), while no correlation between FEV1% and NLR and PLR. RCI’s ability to predict Global Initiative for Chronic Obstructive Lung Disease classification, is better than NLR and PLR, with a cut of 1.75, specificity of 85.2%, sensitivity of 57.6% and area under the curve (AUC) of 0.729 (p = 0.001). Multivariate logistic regression analysis proved RCI was an independent factor affecting lung function in COPD patients (odds ratio [OR] = 4.27, 95%CI: 1.57 - 11.63, p = 0.004). Conclusion: RCI is a novel biomarker that can better assess respiratory function and severity of COPD than NLR and PLR. Higher RCI is independently related to deterioration of respiratory function.


2022 ◽  
Author(s):  
Hirotaka Kinoshita ◽  
Daiki Takekawa ◽  
Takashi Kudo ◽  
Kaori Sawada ◽  
Tatsuya Mikami ◽  
...  

Abstract Relationships between the neutrophil-lymphocyte ratio (NLR) and/or the platelet-lymphocyte ratio (PLR) and neuroinflammatory diseases have been reported. Depression is also associated with neuroinflammation. Here, we determined the association between the NLR, PLR, and depression. This cross-sectional study is a secondary analysis of the data of the Iwaki Health Promotion Project 2017. We analyzed the characteristics and laboratory data of 1,015 Japanese subjects (597 females, 408 males) including their NLR and PLR values. We assigned the subjects with a Center for Epidemiologic Studies Depression Scale (CES-D) score ≥16 to the depression group. We performed a multivariate logistic regression analysis to determine whether the NLR and/or PLR were associated with depressive symptoms (CES-D ≥16). Two hundred subjects (19.7%; 122 [20.4%] females, 78 [19.1%] males) were assigned to the depression group. There were significant differences between the depression and non-depression groups in the NLR [median (25th to 75th percentile): 1.54 (1.24, 1.97) vs. 1.76 (1.32, 2.37), p=0.005] and the PLR [median (25th to 75th percentile): 123.7 (102.0, 153.9) vs. 136.8 (107.0, 166.5), p=0.047] in males, but not in females. The multivariate logistic regression analysis demonstrated that the NLR was significantly associated with depression in the males (adjusted odds ratio: per 1 increase, 1.570; 95% confidence interval: 1.120–2.220; p=0.009). In conclusion, our findings indicate that higher NLR may be associated with depressive symptoms in males.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yanhua Zhen ◽  
Zhihui Chang ◽  
Zhaoyu Liu ◽  
Jiahe Zheng

Abstract Background Inflammatory reaction is an essential factor in the occurrence, development and prognosis of femoropopliteal disease (FPD). The ratio of platelets to lymphocytes (PLR) is a new indicator reflecting platelet aggregation and burden of systemic inflammation. Our study is to explore the association between preoperative platelet-to-lymphocyte ratio (pre-PLR) and 6-month primary patency (PP) after drug-coated balloon (DCB) in FPD. Methods There were 70 patients who underwent DCB for FPD contained in the study. According to 6-month PP, patients were divided into group A (PP ≥6 months, n = 54) and group B (PP < 6 months, n = 16). Logistic regression analysis was used to identify potential predictors for 6-month PP after DCB in FPD. A receiver operating characteristic (ROC) curve analysis was used to identify the cut-off value of pre-PLR to predict 6-month PP. Results Logistic regression analysis showed that pre-PLR (OR: 1.008, 95% CI: 1.001–1.016, P = 0.031) and lesion length > 10 cm (OR: 4.305, 95% CI: 1.061–17.465, P = 0.041) were independently predictive for 6-month PP. The cutoff value of pre-PLR obtained from the ROC analysis was 127.35 to determine 6-month PP with the area of 0.839. Subgroup analysis was conducted based on the cutoff value of pre-PLR. The 6-month PP in the group of pre-PLR < 127.35 was higher than that of pre-PLR ≥ 127.35 group (p < 0.001). Conclusions The present study indicated that an elevated pre-PLR was an effective additional indicator for predicting early PP in FPD after DCB.


2020 ◽  
Author(s):  
Xiaoyue Wang ◽  
Desheng Jiang ◽  
Huang Huang ◽  
Xiaofeng Chen ◽  
Chunlei Zhou ◽  
...  

Abstract Objective The aim of this study was to identify early warning signs for severe novel coronavirus-infected pneumonia (COVID-19).Methods We retrospectively analyzed the clinical data of 90 patients with COVID-19 at the Guanggu District of Hubei Women and Children Medical and Healthcare Center comprising 60 mild cases and 30 severe cases. The demographic data, underlying diseases, clinical manifestations and laboratory blood test results were compared between the two groups. Logistic regression analysis was performed to identify the independent risk factors that predicted severe COVID-19. The receiver-operating characteristic (ROC) curve of independent risk factors was calculated, and the area under the curve (AUC) was used to evaluate the efficiency of the prediction of severe COVID-19.Results The patients with mild and severe COVID-19 showed significant differences in terms of cancer incidence, age, pretreatment neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) and the serum albumin (ALB) level (P<0.05). The severity of COVID-19 was correlated positively with the comorbidity of cancer, age, NLR, and CRP but was negatively correlated with the ALB level (P<0.05). Multivariate logistic regression analysis showed that the NLR and ALB level were independent risk factors for severe COVID-19 (OR=1.319, 95% CI: 1.043-1.669, P=0.021; OR=0.739, 95% CI: 0.616-0.886, P=0.001), with AUCs of 0.851 and 0.128, respectively. An NLR of 4.939 corresponded to the maximum joint sensitivity and specificity according to the ROC curve (0.700 and 0.917, respectively).Conclusion An increased NLR can serve as an early warning sign of severe COVID-19.


2019 ◽  
Vol 2 (1) ◽  
pp. 27-33
Author(s):  
Megawati Sinambela ◽  
Evi Erianty Hasibuan

Antenatal care is a service provided to pregnant women to monitor, support maternal health and detect mothers whether normal or problematic pregnant women. According to the WHO, globally more than 70% of maternal deaths are caused by complications of pregnancy and childbirth such as hemorrhage, hypertension, sepsis, and abortion. Based on data obtained from the profile of the North Sumatra provincial health office in 2017, in the city of Padangsidimpuan in 2017 the coverage of ANC visits reached (76.58%) and had not reached the target in accordance with the 2017 Provincial Health Office strategy plan (95%). This type of research was an observational analytic study with a cross sectional design. The population in this study were independent practice midwives who were in the Padangsidimpuan, the sample in this study amounted to 102 respondents. The technique of collecting data used questionnaires and data analysis used univariate, bivariate and multivariate analysis with logistic regression analysis. Based on bivariate analysis showed that there was a relationship between facilities, knowledge and attitudes of independent midwives with compliance with the standards of antenatal care services with a value of p <0.05. The results of the study with multivariate logistic regression analysis showed that the factors associated with the compliance of independent midwives in carrying out antenatal care service standards were attitudes with values (p = 0.026).


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