scholarly journals Platelet to lymphocyte and neutrophil to lymphocyte ratios as strong predictors of mortality in intensive care population

2019 ◽  
Vol 65 (5) ◽  
pp. 633-636 ◽  
Author(s):  
Ibrahim Karagoz ◽  
Hamit Yoldas

SUMMARY OBJECTIVE: Patients in intensive care units (ICU) have greater morbidity and mortality. We aimed to study neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in the ICU population. METHODS: Medical and laboratory data of patients treated in ICU were retrospectively analyzed. Patients were divided into deceased and survived groups. RESULTS: The NLR of survived and deceased groups were 3.6 (0.2-31) and 9.5 (1-40), respectively (p<0.001). The PLR of the survived group (111 [16-537]) was significantly lower than the PLR of the deceased (209 [52-1143]), (p<0.001). An NLR higher than 4.9 had 84% sensitivity and 67% specificity is selecting deceased patients (AUC:0.80, p<0.001). A PLR higher than 112 had 83% sensitivity and 52% specificity in predicting deadly cases (AUC:0.76, p<0.001). Both PLR and NLR were significantly and positively correlated with c reactive protein levels. CONCLUSION: We suggest that physicians should pay particular attention to the treatment of patients in ICU with elevated NLR and PLR.

Author(s):  
Hasan Hüseyin Özdemir ◽  
Ahmet Dönder

Abstract Objectives A tension headache is the most common type of headache, and its causes are multifactorial. A relationship has been shown between migraine headaches and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP). In this study, we investigated the NLR, PLR, and serum CRP levels in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) patients. Materials and Methods This retrospective study included 64 patients with FETTH, 80 patients with CTTH, and 60 healthy controls who were followed up in the neurology clinic. Hematological parameters were compared between the patient and control groups. Results In CTTH patients, platelets, NLR, PLR, and CRP values were statistically higher than in FETTH patients and patients in the control group. In FETTH patients, the PLR value was higher than in patients in the control group, but there was no statistically significant difference in NLR and CRP values between FETTH patients and patients in the control group. Also, there was no correlation between these values and age and gender. Conclusion Increase platelet count might have an effect on tension-type headache pathophysiology. Systemic inflammation parameters were shown to be significantly higher in CTTH patients. More comprehensive studies are needed to evaluate the effect of systemic inflammation on the chronicity of tension headaches.


2017 ◽  
Vol 16 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Hasan Metineren ◽  
Turan Cihan Dülgeroğlu

This study compared the effectiveness of the neutrophil/lymphocyte ratio (NLR) versus C-reactive protein (CRP) for evaluating the prognosis and degree of inflammation in patients with amputation for a diabetic foot ulcer (DFU). This study enrolled 56 patients with amputations for DFU with gangrene and compared the CRP levels and NLR measured before and after surgery. Overall, 24 patients (42%) died within 2 weeks postoperatively. Mortality increased with a preoperative/postoperative CRP difference ≤1.5 ( P < .001) and age 73 years or older ( P < .001). The postoperative NLR was lower than the preoperative value but was not significant as a prognostic or inflammatory marker ( P = .945). An increasing serum CRP level is a significant predictor of mortality. CRP and old age are reliable prognostic factors in patients with DFU.


2021 ◽  
Vol 67 (10) ◽  
pp. 1498-1502
Author(s):  
Hasan Ergenç ◽  
Zeynep Ergenç ◽  
Muharrem Dog˘an ◽  
Mustafa Usanmaz ◽  
Hasan Tahsin Gozdas

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15505-e15505 ◽  
Author(s):  
Georgy M. Manikhas ◽  
Natalia P. Beliak ◽  
Svetlana I. Kutukova ◽  
Natalia V. Zhukova ◽  
Natalia V. Popova ◽  
...  

e15505 Background: Inflammation seems to be significant factor in carcinogenesis and tumor progression of numerous cancers. Blood calculated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), lactate dehydrogenase (LDH), international normalized ratio (INR) can be evaluated as systemic inflammation markers and prognostic biomarker for many aims: survival outcomes, lymph node metastasis and recurrence, treatment responses in a variety of cancers. The purpose of this study was to investigate baseline associations between blood test parameters (NLR, PLR, LDH, CRP, INR) and their prognostic biomarker role for patient with metastatic gastric cancer, undergoing first-line chemotherapy Methods: Potential baseline inflammatory markers (platelets, neutrophils, lymphocytes, the platelet-lymphocyte ratio, the neutrophil-lymphocyte ratio, the serum C-reactive protein [CRP], the serum LDH, INR) were retrospectively analyzed in 32 patients with metastatic gastric cancer, IV stage (median of age – 60,50). Multivariate analyses were used to identify prognostic factors for overall survival (OS). Baseline values were compared with tumor characteristic and median survival times (MSTs). Results: Multivariate analysis identified due to Cox proportional-hazards regression showed significant longest OS in patients with: localization of primary tumor in antral part of gastric (HR 0,45, 95% CI 0,25-0,80, p = 0,0065); low baseline’s level of WBC (HR 1,17, 95% CI 1.02 - 1,35, p = 0,0219); low baseline’s level of neutrophil (HR 1,18, 95% CI 1.02 - 1,34, p = 0,0251). Level of LDH, CRP, INR didn’t show significant ratio for this cohort of patient. Peritoneum metastatic also didn’t significant affect on OS in patient with metastatic gastric cancer. Patients with low baseline’s platelet to lymphocyte ratio (HR 1,004, 95% CI 1,0009-1,0072, p = 0,0125) and low (from 0 to 3,0) neutrophil to lymphocyte ratio (HR 1,81, 95% CI 1,09-2,99, p = 0,0212) had a significantly longest OS time. Conclusions: Inflammatory markers can predict overall survival in stage IV gastric cancer. Simple and useful.


2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S225-S225
Author(s):  
V Macedo Silva ◽  
M Freitas ◽  
S Xavier ◽  
T Cúrdia Gonçalves ◽  
P Boal Carvalho ◽  
...  

Abstract Background The platelet-to-lymphocyte ratio (PLR) index has been a recent focus of investigation as a reliable marker of inflammation. This score was recently shown to have a good accuracy upon predicting endoscopic remission in patients with colonic Crohn’s Disease (CD). We aimed to assess the discriminative power of PLR index in patients with isolated small bowel CD. Methods Single center study of consecutive patients with isolated small bowel CD (L1 ± L4 disease according to Montreal classification) who underwent small bowel capsule endoscopy (SBCE) for assessment of endoscopic activity between January 2019 and December 2020. Only complete SBCEs were considered. CD endoscopic activity was classified according to the Lewis score (LS) value. Complete blood count, C-reactive protein and fecal calprotectin values were collected within 1 month of SBCE. Results Final sample included 49 patients, 35 (71.4%) of them females, with a mean age of 35.1±11.8 years. SBCE reported mucosal healing (LS&lt;135) in 30.6% of the patients; mild activity (135≤LS&lt;790) in 42.9% and moderate-to-severe activity (LS≥790) in 26.5% of the patients. PLR index positive correlation with LS was significant and moderate (k=0.597; p&lt;0.001). This correlation was stronger than the one seen between fecal calprotectin (k=0.525; p=0.001) or C-reactive protein (k=0.321; p=0.029) and the LS score. In particular, PLR index presented an excellent accuracy for predicting patients with a moderate-to-severe endoscopic activity (AUC=0.908; 95%CI=0.816–0.999; p&lt;0.001), with an optimal cut-off of PLR above 157 (sensitivity 92.3%; specificity 82.9%). The accuracy for prediction of mucosal healing was good (AUC=0.743; 95%CI=0.600–0.887; p=0.007), with an optimal cut-off of PLR below 126 (sensitivity 66.7%; specificity 80.0%). Conclusion PLR index demonstrated an excellent acuity for predicting patients with moderate to severe disease in small bowel CD. Moreover, it also demonstrated good acuity for predicting mucosal healing on this set of patients. These results come from a significant correlation of PLR index with endoscopic activity in small bowel CD. Our findings establish this index as a promising and easy-to-apply tool for non-invasive and regular follow-up of patients with small bowel CD.


2020 ◽  
Vol 3 ◽  
pp. 80
Author(s):  
Brendan O’Kelly ◽  
Colm Cronin ◽  
Stephen Peter Connolly ◽  
Walter Cullen ◽  
Gordana Avramovic ◽  
...  

Background: Ireland has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While several cohorts from China have been described, there is little data describing the epidemiological and clinical characteristics of Irish patients with COVID-19. To improve our understanding of this infection we performed a retrospective review of patient data to examine the clinical characteristics of patients admitted for COVID-19 hospital treatment. Methods: Demographic, clinical and laboratory data on the first 100 patients admitted to Mater Misericordiae University Hospital for in-patient COVID-19 treatment after onset of the outbreak in March 2020 was extracted from patient records. Results: The median age was 45 years (interquartile range [IQR] =34-64 years), 58% were male, and 63% were Irish nationals. Patients had symptoms for a median of five days before diagnosis (IQR=2.5-7 days), most commonly cough (72%), fever (65%), dyspnoea (37%), fatigue (28%), myalgia (27%) and headache (24%). Of all cases, 54 had at least one pre-existing chronic illness (most commonly hypertension, diabetes mellitus or asthma). At initial assessment, the most common abnormal findings were: C-reactive protein >7.0mg/L (74%), ferritin >247μg/L (women) or >275μg/L (men) (62%), D-dimer >0.5μg/dL (62%), chest imaging (59%), NEWS Score (modified) of ≥3 (55%) and heart rate >90/min (51%). Supplemental oxygen was required by 27 patients, of which 17 were admitted to the intensive care unit - 14 requiring ventilation. Antiviral therapy was administered to 40 patients (most commonly hydroxychloroquine or lopinavir/ritonavir). Four died, 17 were admitted to intensive care, and 74 were discharged home, with nine days the median hospital stay (IQR=6-11). Conclusion: Our findings reinforce the consensus of COVID-19 as an acute life-threatening disease and highlights the importance of laboratory (ferritin, C-reactive protein, D-dimer) and radiological parameters, in addition to clinical parameters. Further cohort studies followed longitudinally are a priority.


2020 ◽  
Author(s):  
Yoshihiro Araki ◽  
Norio Yamamoto ◽  
Katsuhiro Hayashi ◽  
Akihiko Takeuchi ◽  
Shinji Miwa ◽  
...  

Abstract Background: Systemic inflammation responses have been associated with cancer development, progression and metastasis. However, little is known about the risk of metastasis based on inflammatory-based scores in patients with osteosarcoma before treatment. We therefore estimated the predictive value of these parameters for metastasis in osteosarcoma.Methods: A total of 54 osteosarcoma patients were enrolled in this retrospective study. All had been diagnosed histologically, and their laboratory data at the first visit were collected from medical records. The lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), monocyte-neutrophil ratio (MNR), platelet-lymphocyte ratio (PLR), Glasgow prognostic score (GPS), neutrophil-platelet score (NPS), neutrophil counts (NC), lymphocyte counts (LC), monocyte counts (MC), and C-reactive protein (CRP) were evaluated.Results: High values of CRP, PLR, MNR, and NPS and a low NC were significantly associated with metastasis of osteosarcoma patients in the univariate analysis. A multivariate Cox regression analysis revealed that a high CRP level (>0.6mg/dL) (hazard ratio=9.7, 95% confidence interval=3.0-31 ; p=0.00010) and low NC (<4087/µL) (hazard ratio=0.13, 95% confidence interval =0.040-0.42 ; p=0.00080) were risk factors significantly associated with metastasis of osteosarcoma patients.Conclusions: Our study demonstrated that the combination of a high CRP level and low NC before treatment was a useful inflammatory-based prognostic indicator for metastasis in patients with osteosarcoma.


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