scholarly journals Prognostic value of neutrophil- lymphocyte count ratio (NLCR) among adult ICU patients in comparison to APACHE II score and conventional inflammatory markers: a multi center retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tao Zhou ◽  
Nan Zheng ◽  
Xiang Li ◽  
Dongmei Zhu ◽  
Yi Han
Keyword(s):  
Cohort Study ◽  
Critical Illness ◽  
Retrospective Cohort Study ◽  
Lymphocyte Count ◽  
Inflammatory Markers ◽  
Retrospective Cohort ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Icu Patients ◽  
Count Ratio

Abstract Background Neutrophil-lymphocyte count ratio (NLCR) has been reported as better indicator of bacteremia than procalcitonin (PCT), and more precise predictor of mortality than C-reactive protein (CRP) under various medical conditions. However, large controversy remains upon this topic. To address the discrepancy, our group has compared the efficiency of NLCR with conventional inflammatory markers in predicting the prognosis of critical illness. Methods We performed a multi-center retrospective cohort study involving 536 ICU patients with outcomes of survival, 28- and 7-day mortality. NLCR was compared with conventional inflammatory markers such as PCT, CRP, serum lactate (LAC), white blood cell, neutrophil and severity score APACHE II (Acute Physiology and Chronic Health Evaluation II) to evaluate the potential outcomes of critical illness. Then, receiver operating characteristics (ROC) curves were constructed to assess and compare each marker’s sensitivity and specificity respectively. Results NLCR values were not different between survival and mortality groups. Meanwhile, remarkable differences were observed upon APACHE II score, CRP, PCT and LAC levels between survival and death groups. ROC analysis revealed that NLCR was not competent to predict prognosis of critical illness. The AUROCs of conventional markers such as CRP, PCT, LAC and APACHE II score were more effective in predicting 28- and 7-day mortality. Conclusions NLCR is less reliable than conventional markers CRP, PCT, LAC and APACHE II score in assessing severity and in predicting outcomes of critical illness.

scholarly journals Neutrophil-Lymphocyte Count Ratio Better Predict Prognosis than Conventional Markers in Critical Patients? A Multiple-Centered Retrospective Cohort Study

2020 ◽  
Author(s):  
Tao Zhou ◽  
Nan Zheng ◽  
Xiang Li ◽  
Dongmei Zhu ◽  
YI HAN
Keyword(s):  
Cohort Study ◽  
Critical Illness ◽  
Retrospective Cohort Study ◽  
Lymphocyte Count ◽  
Inflammatory Markers ◽  
Retrospective Cohort ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Reactive Protein

Abstract Background: Neutrophil-lymphocyte count ratio (NLCR) has been reported as better indicator of bacteremia than procalcitonin (PCT), and better predictor of mortality than C-reactive protein (CRP) in various medical conditions. However, large controversy remains upon this topic. We compared the efficiency of NLCR with conventional inflammatory markers in predicting the prognosis of critical illness. Methods: We performed a multiple-centered retrospective cohort study consisting of 536 ICU patients with outcomes of survival, 28- and 7-day mortality. NLCR was compared with conventional inflammatory markers such as PCT, C-reactive protein (CRP), serum lactate (LAC), white blood cell, neutrophil and severity score APACHE II (Acute Physiology and Chronic Health Evaluation II) to evaluate the predictive value on outcomes of critical illness. Then receiver operating characteristics (ROC) curves were constructed to assess and compare each marker’s sensitivity and specificity respectively. Results: NLCR values were not differential among survival and mortality groups. Meanwhile remarkable differences were observed upon APACHE II score, CRP, PCT and LAC levels among survival and death groups. ROC analysis revealed that NLCR was not competent to predict prognosis of critical illness. The AUROCs of conventional markers such as CRP, PCT, LAC and APACHE II score were more significant in predicting 28- and 7-day mortality. Conclusions: NLCR is not competent and less reliable than conventional markers CRP, PCT, LAC and APACHE II score in assessing severity and in predicting outcomes of critical illness.

scholarly journals Neutrophil-lymphocyte count ratio better predict prognosis than conventional markers in critical patients? A multiple-centered retrospective cohort study

2020 ◽  
Author(s):  
Tao Zhou ◽  
Nan Zheng ◽  
Xiang Li ◽  
Dongmei Zhu ◽  
Yi Han
Keyword(s):  
Cohort Study ◽  
Critical Illness ◽  
Retrospective Cohort Study ◽  
Lymphocyte Count ◽  
Inflammatory Markers ◽  
Retrospective Cohort ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Reactive Protein

Abstract Background: Neutrophil-lymphocyte count ratio (NLCR) has been reported as better indicator of bacteremia than procalcitonin (PCT), and better predictor of mortality than C-reactive protein (CRP) in various medical conditions. However, large controversy remains upon this topic. We compared the efficiency of NLCR with conventional inflammatory markers in predicting the prognosis of critical illness. Methods: We performed a multiple-centered retrospective cohort study consisting of 536 ICU patients with outcomes of survival, 28- and 7-day mortality. NLCR was compared with conventional inflammatory markers such as PCT, C-reactive protein (CRP), serum lactate (LAC), white blood cell, neutrophil and severity score APACHE II (Acute Physiology and Chronic Health Evaluation II) to evaluate the predictive value on outcomes of critical illness. Then receiver operating characteristics (ROC) curves were constructed to assess and compare each marker’s sensitivity and specificity respectively. Results: NLCR values were not differential among survival and mortality groups. Meanwhile remarkable differences were observed upon APACHE II score, CRP, PCT and LAC levels among survival and death groups. ROC analysis revealed that NLCR was not competent to predict prognosis of critical illness. The AUROCs of conventional markers such as CRP, PCT, LAC and APACHE II score were more significant in predicting 28- and 7-day mortality. Conclusions: NLCR is not competent and less reliable than conventional markers CRP, PCT, LAC and APACHE II score in assessing severity and in predicting outcomes of critical illness.

Predicting Long-term Cognitive Dysfunction in Survivors of Critical Illness with Plasma Inflammatory Markers: a Retrospective Cohort Study

2018 ◽  
Vol 56 (1) ◽  
pp. 763-767 ◽  
Author(s):  
Marcus Maciel ◽  
Sabrina Ronconi Benedet ◽  
Elizabeth Buss Lunardelli ◽  
Henrique Delziovo ◽  
Rayane Lima Domingues ◽  
...  
Keyword(s):  
Cohort Study ◽  
Critical Illness ◽  
Cognitive Dysfunction ◽  
Retrospective Cohort Study ◽  
Inflammatory Markers ◽  
Retrospective Cohort

scholarly journals Early predictive factors of progression from severe type to critical ill type in patients with Coronavirus Disease 2019: A retrospective cohort study

2020 ◽  
Author(s):  
Nan Li ◽  
Hao Kong ◽  
Xi-Zi Zheng ◽  
Xue-Ying Li ◽  
Jing Ma ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Cohort Study ◽  
Critical Illness ◽  
Hospital Admission ◽  
Neutrophil Count ◽  
Retrospective Cohort Study ◽  
Lymphocyte Count ◽  
Retrospective Cohort ◽  
Creatine Kinase Mb ◽  
Critical Ill

Abstract Background: The current worldwide pandemic of Coronavirus Disease 2019 (COVID-19) has posed a serious threat to global public health, and the mortality rate of critical ill patients remains high. The purpose of this study was to identify factors that early predict the progression of COVID-19 from severe to critical illness.Methods: This retrospective cohort study included adult patients with severe or critical ill COVID-19 who were consecutively admitted to the Zhongfaxincheng campus of Tongji Hospital (Wuhan, China) from February 8 to 18, 2020. Baseline variables, data at hospital admission and during hospital stay, as well as clinical outcomes were collected from electronic medical records system. The primary endpoint was the development of critical illness. A multivariable logistic regression model was used to identify independent factors that were associated with the progression from severe to critical illness.Results: A total of 138 patients were included in the analysis; of them 119 were diagnosed as severe cases and 16 as critical ill cases at hospital admission. During hospital stay, 19 more severe cases progressed to critical illness. For all enrolled patients, longer duration from diagnosis to admission (odds ratio [OR] 1.108, 95% CI 1.022-1.202; P=0.013), pulse oxygen saturation at admission <93% (OR 5.775, 95% CI 1.257-26.535; P=0.024), higher neutrophil count (OR 1.495, 95% CI 1.177-1.899; P=0.001) and higher creatine kinase-MB level at admission (OR 2.449, 95% CI 1.089-5.511; P=0.030) were associated with a higher risk, whereas higher lymphocyte count at admission (OR 0.149, 95% CI 0.026-0.852; P=0.032) was associated with a lower risk of critical illness development. For the subgroup of severe cases at hospital admission, the above factors except creatine kinase-MB level were also found to have similar correlation with critical illness development.Conclusions: Higher neutrophil count and lower lymphocyte count at admission were early independent predictors of progression to critical illness in severe COVID-19 patients.

scholarly journals Eosinophil Count and Neutrophil-Lymphocyte Count Ratio as Prognostic Markers in Patients with Bacteremia: A Retrospective Cohort Study

PLoS ONE ◽  
2012 ◽  
Vol 7 (8) ◽  
pp. e42860 ◽  
Author(s):  
Roser Terradas ◽  
Santiago Grau ◽  
Jordi Blanch ◽  
Marta Riu ◽  
Pere Saballs ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Eosinophil Count ◽  
Lymphocyte Count ◽  
Retrospective Cohort ◽  
Prognostic Markers ◽  
Count Ratio

scholarly journals Early predictive factors of progression from severe type to critical ill type in patients with Coronavirus Disease 2019: A retrospective cohort study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243195 ◽  
Author(s):  
Nan Li ◽  
Hao Kong ◽  
Xi-Zi Zheng ◽  
Xue-Ying Li ◽  
Jing Ma ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Cohort Study ◽  
Critical Illness ◽  
Hospital Admission ◽  
Neutrophil Count ◽  
Retrospective Cohort Study ◽  
Lymphocyte Count ◽  
Retrospective Cohort ◽  
Creatine Kinase Mb ◽  
Critical Ill

Background The current worldwide pandemic of Coronavirus Disease 2019 (COVID-19) has posed a serious threat to global public health, and the mortality rate of critical ill patients remains high. The purpose of this study was to identify factors that early predict the progression of COVID-19 from severe to critical illness. Methods This retrospective cohort study included adult patients with severe or critical ill COVID-19 who were consecutively admitted to the Zhongfaxincheng campus of Tongji Hospital (Wuhan, China) from February 8 to 18, 2020. Baseline variables, data at hospital admission and during hospital stay, as well as clinical outcomes were collected from electronic medical records system. The primary endpoint was the development of critical illness. A multivariable logistic regression model was used to identify independent factors that were associated with the progression from severe to critical illness. Results A total of 138 patients were included in the analysis; of them 119 were diagnosed as severe cases and 16 as critical ill cases at hospital admission. During hospital stay, 19 more severe cases progressed to critical illness. For all enrolled patients, longer duration from diagnosis to admission (odds ratio [OR] 1.108, 95% CI 1.022–1.202; P = 0.013), pulse oxygen saturation at admission <93% (OR 5.775, 95% CI 1.257–26.535; P = 0.024), higher neutrophil count (OR 1.495, 95% CI 1.177–1.899; P = 0.001) and higher creatine kinase-MB level at admission (OR 2.449, 95% CI 1.089–5.511; P = 0.030) were associated with a higher risk, whereas higher lymphocyte count at admission (OR 0.149, 95% CI 0.026–0.852; P = 0.032) was associated with a lower risk of critical illness development. For the subgroup of severe cases at hospital admission, the above factors except creatine kinase-MB level were also found to have similar correlation with critical illness development. Conclusions Higher neutrophil count and lower lymphocyte count at admission were early independent predictors of progression to critical illness in severe COVID-19 patients.

scholarly journals The value of the neutrophil-lymphocyte count ratio in the diagnosis of sepsis in patients admitted to the Intensive Care Unit: A retrospective cohort study

PLoS ONE ◽  
2019 ◽  
Vol 14 (2) ◽  
pp. e0212861 ◽  
Author(s):  
Kim Westerdijk ◽  
Koen S. Simons ◽  
Marissa Zegers ◽  
Peter C. Wever ◽  
Peter Pickkers ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Retrospective Cohort Study ◽  
Lymphocyte Count ◽  
Retrospective Cohort ◽  
Count Ratio

scholarly journals Morbidity and mortality outcomes of COVID-19 patients with and without hypertension in Lagos, Nigeria: A retrospective cohort study

2020 ◽  
Author(s):  
Akin Osibogun ◽  
Akin Abayomi ◽  
Oluchi Kanma-Okafor ◽  
Jide Idris ◽  
Abimbola Bowale ◽  
...  
Keyword(s):  
Cohort Study ◽  
Critical Illness ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Outcome Data ◽  
Morbidity And Mortality ◽  
P Value ◽  
Hypertensive Patients ◽  
Increased Risk

Abstract Background: The current pandemic of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown epidemiological and clinical characteristics that appear worsened in hypertensive patients. The morbidity and mortality of the disease among hypertensive patients in Africa have yet to be well described.Methods: In this retrospective cohort study all confirmed COVID-19 adult patients (≥18 years of age) in Lagos between February 27 to July 6 2020 were included. Demographic, clinical and outcome data were extracted from electronic medical records of patients admitted at the COVID-19 isolation centers in Lagos. Outcomes included dying, being discharged after recovery or being evacuated/transferred. Descriptive statistics considered proportions, means and medians. The Chi-square and Fisher’s exact tests were used in determining associations between variables. Kaplan–Meier survival analysis and Cox regression were performed to quantify the risk of worse outcomes among hypertensives with COVID-19 and adjust for confounders. P-value ≤0.05 was considered statistically significant.Results: A total of 2075 adults with COVID-19 were included in this study. The prevalence of hypertension, the most common comorbidity, was 17.8% followed by diabetes (7.2%) and asthma (2.0%). Overall mortality was 4.2% while mortality among the hypertensives was 13.7%. Severe symptoms and mortality were significantly higher among the hypertensives and survival rates were significantly lowered by the presence of an additional comorbidity to 50% from 91% for those with hypertension alone and from 98% for all other patients (P<0.001). After adjustment for confounders (age and sex), severe COVID-19and death were higher for hypertensives {severe/critical illness: HR=2.41, P=0.001, 95%CI=1.4–4.0, death: HR=2.30, P=0.001, 95%CI=1.2–4.6, for those with hypertension only} {severe/critical illness: HR=3.76, P=0.001, 95%CI=2.1–6.4, death: crude HR=6.63, P=0.001, 95%CI=3.4–1.6, for those with additional comorbidities}. Hypertension posed an increased risk of severe morbidity (approx. 4-fold) and death (approx. 7-fold) from COVID-19 in the presence of multiple comorbidities. Conclusion: The potential morbidity and mortality risks of hypertension especially with other comorbidities in COVID-19 could help direct efforts towards prevention and prognostication. This provides the rationale for improving preventive caution for people with hypertension and other comorbidities and prioritizing them for future antiviral interventions.

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