scholarly journals Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as independent predictors of outcome in infective endocarditis (IE)

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Marwa Sayed Meshaal ◽  
Abdo Nagi ◽  
Ahmed Eldamaty ◽  
Wae’el Elnaggar ◽  
Mervat Gaber ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Infective Endocarditis ◽  
Hospital Mortality ◽  
Roc Curve ◽  
Area Under The Curve ◽  
Neutrophil To Lymphocyte Ratio ◽  
Total Leucocyte Count ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Neutrophil Percentage

Abstract Background Early and accurate risk assessment is an important clinical demand in patients with infective endocarditis (IE). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are independent predictors of prognosis in many infectious and cardiovascular diseases. Very limited studies have been conducted to evaluate the prognostic role of these markers in IE. Results We analyzed clinical, laboratory, and echocardiographic data and outcomes throughout the whole period of hospitalization for a total of 142 consecutive patients with definitive IE. The overall in-hospital mortality was 21%. Major complications defined as central nervous system embolization, fulminant sepsis, acute heart failure, acute renal failure, and major artery embolization occurred in 38 (27%), 34 (24%), 32 (22.5%), 40 (28%), and 90 (63.4%) patients, respectively. The NLR, total leucocyte count (TLC), neutrophil percentage, creatinine, and C-reactive protein (CRP) level obtained upon admission were significantly higher in the mortality group [p ≤ 0.001, p = 0.008, p = 0.001, p = 0.004, and p = 0.036, respectively]. A higher NLR was significantly associated with fulminant sepsis and major arterial embolization [p = 0.001 and p = 0.028, respectively]. The receiver operating characteristic (ROC) curve of the NLR for predicting in-hospital mortality showed that an NLR > 8.085 had a 60% sensitivity and an 84.8% specificity for an association with in-hospital mortality [area under the curve = 0.729, 95% confidence interval (CI) 0.616–0.841; p = 0.001]. The ROC curve of the NLR for predicting severe sepsis showed that an NLR > 5.035 had a 71.8% sensitivity and a 68.5% specificity for predicting severe sepsis [area under the curve 0.685, 95% CI 0.582–0.733; p = 0.001]. The PLR showed no significant association with in-hospital mortality or in-hospital complications. Conclusion A higher NLR, TLC, neutrophil percentage, creatinine level, and CRP level upon admission were associated with increased in-hospital mortality and morbidity in IE patients. Furthermore, a lower lymphocyte count/percentage and platelet count were strong indicators of in-hospital mortality among IE patients. Calculation of the NLR directly from a CBC upon admission may assist in early risk stratification of patients with IE.

scholarly journals Platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in patients with rheumatoid arthritis

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
You-Fan Peng ◽  
Ling Cao ◽  
Yan-Hua Zeng ◽  
Zhao-Xia Zhang ◽  
Dan Chen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Neutrophil Percentage ◽  
Crude Model

AbstractObjectives: It has been well documented that the platelet to lymphocyte ratio (PLR) and the neutrophil to lymphocyte ratio (NLR) are associated with outcomes for patients with gastric cancer, non-small cell lung cancer and acute heart failure. Inflammation may be the hidden factor that explains the correlation between NLP, PLR, and these diseases. However, to date, the data concerning NLR, PLR, and its association with inflammation are lacking in patients with rheumatoid arthritis (RA), thus, our aim to discuss whether NLR and PLR are associated with RA. Methods: Patients with RA and healthy individuals were included according to the determined criteria, and laboratory indicators were measured. Results: PLR and NLR were significantly higher in RA patients compared with healthy controls (3.20±2.06 vs. 1.56±0.47, P<0.01; 192.85±101.78 vs. 103.49±28.68, P<0.01). When leukocytes, neutrophil percentage, neutrophil, lymphocyte, platelet, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF) were considered as confounders (crude model), our results indicated that ESR and RF were correlated to RA. Of note, ESR, RF, and PLR were associated with RA after further adjustment based on crude model for PLR and NLR. Receiver operating characteristic (ROC) curves analysis showed that PLR values higher than >115.7 evaluated RA with a sensitivity of 82.5%, a specificity of 74.8% and area under the curve ( AUC ) of 0.847. Conclusions:Our results suggest that PLR is associated with RA, and PLR may be an underlying indicator indicating the chronic subclinical inflammation in patients with RA.

scholarly journals Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios Predict All-Cause Mortality in Acute Pulmonary Embolism

2020 ◽  
Vol 26 ◽  
pp. 107602961990054 ◽  
Author(s):  
Trung Phan ◽  
Yevgeniy Brailovsky ◽  
Jawed Fareed ◽  
Debra Hoppensteadt ◽  
Omer Iqbal ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Prediction Models ◽  
Area Under The Curve ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Useful Components ◽  
Significant Difference ◽  
All Cause Mortality

The aim of this study was to investigate the utility of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to predict all-cause mortality in patients presenting with acute pulmonary embolism (PE). Three hundred consecutive patients with acute PE between March 2016 and December 2018 were retrospectively analyzed. We identified 191 patients who met the study inclusion criteria. Twenty-eight patients died during the study period. There was a significant difference in PLR, but not NLR, between patients with low risk, submassive, and massive risk PE ( P = .02 and P = .58, respectively, by the Kruskal-Wallis test). Elevated NLR and PLR were associated with all-cause mortality ( P < .01 and P < .01, respectively). Neutrophil-to-lymphocyte ratio of 5.46 was associated with all-cause mortality with sensitivity of 75.0% and specificity of 66.9% (area under the curve [AUC]: 0.692 [95% confidence interval, CI]: 0.568-0.816); P < .01). Platelet-to-lymphocyte ratio of 256.6 was associated with all-cause mortality with sensitivity of 53.6% and specificity of 82.2% (AUC: 0.693 [95% CI: 0.580-0.805]; P < .01). Neutrophil-to-lymphocyte ratio and PLR are simple biomarkers that are readily available from routine laboratory values and may be useful components of PE risk prediction models.

scholarly journals Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) at Admission Are Predictors for Worse Functional Outcome in Cerebral Venous Sinus Thrombosis

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 8-9
Author(s):  
Binbin Zheng ◽  
Qian Wang ◽  
Sridevi Rajeeve ◽  
Biyue Dai ◽  
Cynthia Zevallos ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Functional Outcome ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Selection Scheme ◽  
Venous Sinus Thrombosis ◽  
Lymphocyte Ratio

INTRODUCTION: Cerebral Venous Sinus Thrombosis (CVST) primarily affects children and young adults, especially young women of child-bearing age. Despite overall favorable outcome with systemic anticoagulation, it is still associated with up to 15% mortality and a high incidence of morbidity, resulting in a significant loss of productive life. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) are inflammatory and immunologic serum biomarkers that have been described to be predictive of outcome in arterial and venous thromboembolism events including pulmonary embolism and ischemic stroke. Nonetheless, predictive values of these ratios in CVST are not well established. METHODS: This is a single-center, observational and retrospective study that included patients diagnosed with CVST from January 2004 to December 2016 in University of Iowa Hospitals and Clinics. Patients with age older than 18 years were included. Exclusion criteria were incomplete clinical or laboratory data and patients with active malignancy receiving chemotherapy at the time of CVST diagnosis. Patients' complete blood count obtained at admission was used for ratio calculation. Receiver Operating Characteristic (ROC) curve was used to determine cutoff value for the ratios. Predictive utility of each ratio was evaluated in separate multivariate logistic regression models, conditioned on variables that were already shown to have strong association with mRS outcome in univariate analyses. An Akaike information criterion (AIC)-based backward stepwise selection scheme was used for model selection. Functional outcome was assessed by using modified Rankin score (mRS) which was into good outcome (mRS score of 0 to 2) and poor outcome (mRS score of 3 to 6). A two-sided p-value of 0.05 was considered statistically significant. RESULTS: 134 patients were included; median age was 42 years (IQR = 26.75 years) and 90 (67%) were female. The overall mortality was 9% (N=13). After adjusting by demographic characteristics, presenting symptoms and comorbidities, NLR&gt;6.24 (OR=4.57, 95% CI 1.85 - 11.29, p=0.001) and PLR&gt;144 (OR=4.80, 95% CI 1.95 - 11.82, p=0.001) were statistically associated with poor mRS (mRS 3-6) at hospital discharge. Altered mental status on presentation was independently correlated with poor neurologic outcome and in-hospital mortality. While altered motor function and concomitant infection correlated with higher mRS and higher mortality, respectively. The present study did not observe significant prediction between ratios and in-hospital mortality, being NLR marginally significant (OR= 4.67, 95% CI 0.85 - 25.67, p=0.077). CONCLUSION: To the best of our knowledge, this is the first study that describes a statistically significant association between increased NLR and PLR at admission and poor functional outcome in CVST patients at discharge. Their predictive value could be potentially used in the early identification of high-risk patients who may benefit from more aggressive therapeutic approaches, such as endovascular treatment. Disclosures No relevant conflicts of interest to declare.

scholarly journals Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR) and Risk of Thromboembolism in Patients with Lymphoma

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3649-3649
Author(s):  
Darko Antic ◽  
Natasa Milic ◽  
Vladimir Otasevic ◽  
Tanja Virijevic Salak ◽  
Vladislava Djurasinovic ◽  
...  
Keyword(s):  
Overall Survival ◽  
Risk Factor ◽  
T Cell ◽  
Hodgkin Lymphoma ◽  
Roc Curve ◽  
Response To Therapy ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Non Hodgkin Lymphoma

Background: Thromboembolism (TE) is one of major causes of morbidity and mortality in patients with malignancy. Pathophysiological connection between TE and inflammation has been established and it is being thoroughly studied recently. The neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) are biomarkers for systemic inflammation and might represent a yet unrecognized risk factor for development of venous thromboembolism in lymphoma patients having in mind chronic inflammatory milieu specific for lymphomas. Aims: We aimed to investigate the association between NLR, PLR and future risk of TE, in a prospective cohort of lymphoma patients receiving chemotherapy. Methods: We prospectively included 630 patients with B cell non Hodgkin lymphoma /indolent and agressive/, T cell non Hodgkin lymphoma and Hodgkin lymphoma who were diagnosed and treated (period 2014-2019.) at the Clinic for Hematology, Clinical Center of Serbia. Data for newly diagnosed patients, who had completed a minimum of one chemotherapy cycle, were collected for venous TE events from time of diagnosis to 3 months after the last cycle of therapy. NLR and PLR were calculated according to the CBC with differential count. TE complications were diagnosed based on clinical examination, laboratory evaluation and radiographic studies (duplex venous ultrasound, contrast-enhanced computed tomography scan, magnetic resonance imaging (MRI)). Response to therapy was assessed according to Cheson criteria. Logistic regression analysis and ROC curve were performed to assess the association of NLR and PLR with TE and therapy response. Cox regression and Kaplan Meier analysis were used to assess overall survival. Results: The mean age in our group of patients was 53 years (range, 18-89 years) while 52.8% were males. Most patients had advanced stage disease: clinical stage III 20.6% and stage IV, 41.5%. A total of 327 patients (51.9%) had aggressive NHL; 175 (27.8%) had indolent NHL; 102 (16.2%) had HL; 26 (4.1%) had T cell NHL. 51 (8.2%) patients developed thromboembolic events. NLR and PLR were significantly higher in TE patients compared to patients without TE (p=0.001 and p=0.002, respectively). The NLR was positively associated with PLR (p&lt;0.001). A positive NLR was considered 3 or higher, while a positive PLR was a ratio of 10 or more. The ROC curve analysis demonstrated acceptable specificity and sensitivity of NLR and PLR in predicting TE. NLR and PLR were found to be prognostic factors for the TE (relative risk [RR] = 2.9, 95% confidence interval [CI] = 1.6-5.3, p=0.001 and RR=2.7, 95% CI =1.4-5.1, p=0.002, respectively) as well as for overall response to therapy (RR=2.7, 95%CI=1.7-5.7, p&lt;0.001 and RR=2.0, 95%CI=1.1-3.4, p=0.015, respectively). Regarding the overall survival, in univariate analysis there was an association of the development of TE and decreased survival, while in multivariate model NLR was found to be an independent risk factor for overall survival in lymphoma patients (HR=1.8, 95%CI=1.1-2.9, p=0.024) (Figure 1). Summary/Conclusion: NLR could represent useful clinical predictor of TE complications in patients with lymphoma without additional costs to the national health systems. Our research showed that NLR is also predictive for response to therapy and overall survival of lymphoma patients. Simplicity, cost effectiveness, and rapid turn around qualify this new tool for routine prognostic assessment in lymphoma patients. Figure 1 Disclosures No relevant conflicts of interest to declare.

scholarly journals Prognostic Value of Neutrophil-To-Lymphocyte Ratio and Platelet-To-Lymphocyte Ratio for Renal Outcomes in Patients with Rapidly Progressive Glomerulonephritis

2020 ◽  
Vol 9 (4) ◽  
pp. 1128 ◽  
Author(s):  
Yukari Mae ◽  
Tomoaki Takata ◽  
Ayami Ida ◽  
Masaya Ogawa ◽  
Sosuke Taniguchi ◽  
...  
Keyword(s):  
Renal Function ◽  
Rapidly Progressive Glomerulonephritis ◽  
Area Under The Curve ◽  
Neutrophil To Lymphocyte Ratio ◽  
Renal Outcome ◽  
Maintenance Hemodialysis ◽  
Rapid Decline ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Renal Outcomes

Background: Rapidly progressive glomerulonephritis (RPGN) is a syndrome characterized by a rapid decline in renal function that often causes end-stage renal disease. Although it is important to predict renal outcome in RPGN before initiating immunosuppressive therapies, no simple prognostic indicator has been reported. The aim of this study was to investigate the associations of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to renal outcomes in patients with RPGN. Methods: Forty-four patients with a clinical diagnosis of RPGN who underwent renal biopsy were enrolled. The relationships between NLR and PLR and renal outcome after 1 year were investigated. Results: NLR and PLR were significantly higher in patients with preserved renal function in comparison to patients who required maintenance hemodialysis (p < 0.05 and p < 0.01, respectively). An NLR of 4.0 and a PLR of 137.7 were the cutoff values for renal outcome (area under the curve, 0.782 and 0.819; sensitivity, 78.4% and 89.2%; specificity, 71.4% and 71.4%, respectively). Furthermore, an NLR of 5.0 could predict recovery from renal injury in patients requiring hemodialysis (area under the curve, 0.929; sensitivity, 83.3%; specificity, 85.7%). Conclusion: NLR and PLR could be candidates for predicting renal outcomes in patients with RPGN.

scholarly journals Red Blood Cell Distribution Width, Neutrophil-to-Lymphocyte Ratio, and In-Hospital Mortality in Dyspneic Patients Admitted to the Emergency Department

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Li Yan ◽  
Zhi-De Hu
Keyword(s):  
Emergency Department ◽  
Blood Cell ◽  
Hospital Mortality ◽  
Red Blood Cell ◽  
Roc Curve ◽  
Neutrophil To Lymphocyte Ratio ◽  
Cell Distribution ◽  
Distribution Width ◽  
Lymphocyte Ratio ◽  
Red Blood Cell Distribution

Red blood cell distribution width (RDW) and neutrophil-to-lymphocyte ratio (NLR) have shown a prognostic value in various clinical settings. We aimed to investigate the association between RDW, NLR, and in-hospital mortality in patients with dyspnea. In this retrospective study with the Medical Information Mart for Intensive Care III database (version 1.4), adult patients who came to the emergency department with dyspnea were included. Patients’ comorbidities, hematological parameters within the first 48 hours after admission to the emergency department, and in-hospital mortality were extracted. The relationships between RDW, NLR, and in-hospital mortality were analyzed with the receiver operating characteristic (ROC) curve analysis and multivariate logistic regression model. We found that hospital survivors had significantly lower NLR than those who died. However, RDW was not significantly increased in patients who died during the hospitalization. The area under the ROC curve of NLR for predicting in-hospital mortality was 0.62. On multivariate analysis, NLR was not independently associated with in-hospital mortality. On further analysis, lymphocyte percentage was independently associated with in-hospital mortality, with an odds ratio of 0.56. Therefore, we concluded that RDW and NLR are not reliable parameters to predict in-hospital mortality in critically ill patients admitted to the emergency department with dyspnea.

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio: novel markers for the diagnosis and prognosis in patients with restenosis following CAS

2020 ◽  
Vol 14 (4) ◽  
pp. 271-282 ◽  
Author(s):  
Xiang Bao ◽  
Gezhi Zhou ◽  
Wei Xu ◽  
Xiaobo Liu ◽  
Zhijun Ye ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Receiver Operating Characteristic Analysis ◽  
Prognostic Significance ◽  
Area Under The Curve ◽  
Prognostic Indicator ◽  
Neutrophil To Lymphocyte Ratio ◽  
Characteristic Analysis ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Diagnosis And Prognosis

Aim: In this study, we investigated the effect of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio on restenosis status in patients undergoing carotid angioplasty stenting (CAS). Methodology & results: Clinical imageology and receiver operating characteristic analysis were utilized to study the prognostic significance of NLRs/platelet-to-lymphocyte ratios and their correlation with survival. NLR of restenosis (+) patients was evidently increased after the CAS procedures, while the NLR of restenosis (-) patients before the CAS procedures being the lowest. Area under the curve of pre-CAS NLR or/and post-CAS NLR were all evidently higher than 50%. Also, restenosis incidence was the highest in patients with both high pre-CAS and high post-CAS values. Conclusion: Therefore, NLR can be utilized as an independent prognostic indicator to predict the incidence of restenosis after CAS procedures.

scholarly journals NEUTROPHIL TO LYMPHOCYTE RATIO VS PLATELETS TO LYMPHOCYTE RATIO: BIOMARKERS TO PREDICT SEVERITY OF DISEASE AND THEIR COMPARISON IN PATIENTS OF COVID-19

2020 ◽  
Vol 70 (6) ◽  
pp. 1609-15
Author(s):  
Muhammad Adil ◽  
Zahid Farooq Baig ◽  
Muhammad Amir ◽  
Sohail Saqib Chatha ◽  
Aamir Habib ◽  
...  
Keyword(s):  
Virus Disease ◽  
Severe Disease ◽  
Area Under The Curve ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Severity Of Disease ◽  
Significant Area ◽  
Polymerase Chain ◽  
Complete Blood Counts

Objective: To determine and compare Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) in predicting severity of disease in patients with COVID-19. Study design: Descriptive comparative study. Place and Duration of study:  Department of Medicine, CMH Thal from April to July, 2020 Patients & Methods: 61 patients of COVID-19 confirmed through polymerase chain reaction were recruited and divided into severe and non severe disease. Complete blood counts were done. Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio were calculated and analyzed. Results: 14 patients (23%) of severe disease had mean age of 49.93±19.42 and 47 patients (77%) with non-severe disease had mean age of 33.32±9.16. The mean Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte ratio in patients who had severe disease was 7.20±4.20 and 204.25±148.42 (p=0.001 and p=0.026) respectively. The diagnostic performance of both Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio produced statistically significant area under the curve (AUC), (p <0.001). The adjusted and unadjusted area under curve for Neutrophil to Lymphocyte Ratio was 0.92 (95% CI: 0.85–1.00) and 0.923 (95% CI: 0.839-1.000) and for Platelet to Lymphocyte Ratio it was 0.883 (95% CI: 0.781–0.985) and 0.825(95% CI:  0.707-0.943) respectively.  Conclusion: Elevated Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio are independent biomarkers which predict severity of disease in COVID-19 patients with Neutrophil to Lymphocyte Ratio being better predictor in terms of diagnostic accuracy.  Keywords: Corona virus disease 2019 (COVID‐19), Neutrophil to Lymphocyte ratio, Platelet to Lymphocyte ratio

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