Neutrophil-to-Lymphocyte Ratio Cut-Off Point for COVID-19 Mortality: A Retrospective Study

2022 ◽  
Author(s):  
Zahedin Kheyri ◽  
Sepehr Metanat ◽  
Hadiseh Hosamirudsari ◽  
Samaneh Akbarpour ◽  
Maryam Shojaei ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Regression Models ◽  
Neutrophil To Lymphocyte Ratio ◽  
Rt Pcr ◽  
Multivariate Logistic Regression ◽  
Logistic Regression Models ◽  
Lymphocyte Ratio ◽  
Icu Admission ◽  
Prolonged Hospitalization ◽  
Multiple Characteristics

Several months have passed since the onset of the COVID-19 pandemic. Multiple characteristics have been proposed as prognostic factors so far. This study aims to provide evidence on the association of neutrophil-to-lymphocyte ratio (NLR) at the hospitalization time and three desired outcomes (mortality, prolonged hospitalization, and intensive care unit [ICU] admission). We designed a single-centre retrospective observational study in Baharloo Hospital (Tehran, Iran) from 20 February to 19 April 2020. Patients with confirmed COVID-19 diagnosis via rt-PCR or chest CT imaging were included. Demographic and clinical data were obtained. The sample was divided into three groups, using tertile boundaries of initial NLR. The differences in mortality, comorbidities, hospitalization duration, drug administration, and ICU admission between these three groups were investigated. The identified confounding factors were adjusted to calculate the odds ratio of death, ICU admission, and prolonged hospitalization. Nine hundred sixty-three patients were included. In total, 151 and 212 participants experienced mortality and ICU admission, respectively. In multivariate logistic regression models, the adjusted odds ratio for mortality event in the second and third tertile of initial NLR after full adjustment were 1.89 (95% CI:1.07-3.32) and 2.57 (95% CI:1.48-4.43) and for ICU admission were 1.85 (95% CI:1.14-3.01) and 2.88 (95% CI:1.79-4.61), respectively. The optimal cut-off value of the initial NLR for predicting mortality was 4.27. Initial NLR can predict mortality and ICU admission in COVID-19 patients. Further investigations for curating the calculated cut-off can propose initial NLR as an indicator of poor prognosis for COVID-19 patients.

scholarly journals Hemogram Rates as Prognostic Markers of ICU Admission in COVID-19

2021 ◽  
Author(s):  
Sara Velazquez ◽  
Rodrigo Madurga ◽  
Jose Maria Castellano ◽  
Jesus Rodriguez-Pascual ◽  
Santiago Ruiz de Aguiar ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Regression Models ◽  
Complex Model ◽  
Pathophysiological Mechanism ◽  
The Novel ◽  
Prothrombotic State ◽  
Logistic Regression Models ◽  
Lymphocyte Ratio ◽  
Icu Admission ◽  
The Moment

Abstract BackgroundSince first cases of SARS COV-2 were identified, the number of affected and dead people make necessary to identify factors related to worse evolution. Endothelial injury has been proposed as the main pathophysiological mechanism in the illness development, which provokes a hyper inflammation and prothrombotic state. Leukocytes and platelets play a role in inflammation and thrombogenesis so we propose to study if neutrophil-to-lymphocyte ratio (NLR), platelets-to-lymphocyte ratio (PLR), the novel neutrophil-to-platelet ratio (NPR), and the systemic immune-inflammation index (SII), could be useful to identify patients who will need admission at Intensive Care Units.MethodsA retrospective observational study was performed at HM Hospitales including 2245 patients with COVID-19 from March 1 to June 10, 2020. Patients were divided into two groups, admitted, and not admitted to ICU. ResultsPatients requiring ICU admission had significantly higher rates at the moment of hospital admission in NLR (6.9 [4–11.7] vs 4.1 [2.6–7.6], p<0.0001), PLR (2 [1.4–3.3] vs 1.9 [1.3–2.9], p=0.023), NPR (3 [2.1–4.2] vs 2.3 [1.6–3.2], p<0.0001) and SII (13 [6.5–25.7] vs 9 [4.9–17.5], p<0.0001) than those who did not enter ICU. After multivariable logistic regression models, the hemogram rate that better remains as a predictor of ICU admission, when adjusted for the more complex model, was NPR, OR 1.11 (95% CI: 0.98-1.22, p=0.055).ConclusionsThe four rates obtained from hemogram at hospital admission, especially the novelty NPR, have shown to be useful as predictors of unfavorable clinical evolution.

scholarly journals Hemogram-derived ratios as prognostic markers of ICU admission in COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara Velazquez ◽  
Rodrigo Madurga ◽  
José María Castellano ◽  
Jesús Rodriguez-Pascual ◽  
Santiago Ruiz de Aguiar Diaz Obregon ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Regression Models ◽  
Prognostic Markers ◽  
Clinical Parameter ◽  
Prothrombotic State ◽  
Health Records ◽  
Logistic Regression Models ◽  
Lymphocyte Ratio ◽  
Icu Admission ◽  
The Moment

Abstract Background The vast impact of COVID-19 call for the identification of clinical parameter that can help predict a torpid evolution. Among these, endothelial injury has been proposed as one of the main pathophysiological mechanisms underlying the disease, promoting a hyperinflammatory and prothrombotic state leading to worse clinical outcomes. Leukocytes and platelets play a key role in inflammation and thrombogenesis, hence the objective of the current study was to study whether neutrophil-to-lymphocyte ratio (NLR), platelets-to-lymphocyte ratio (PLR), the systemic immune-inflammation index (SII) as well as the new parameter neutrophil-to-platelet ratio (NPR), could help identify patients who at risk of admission at Intensive Care Units. Methods A retrospective observational study was performed at HM Hospitales including electronic health records from 2245 patients admitted due to COVID-19 from March 1 to June 10, 2020. Patients were divided into two groups, admitted at ICU or not. Results Patients who were admitted at the ICU had significantly higher values in all hemogram-derived ratios at the moment of hospital admission compared to those who did not need ICU admission. Specifically, we found significant differences in NLR (6.9 [4–11.7] vs 4.1 [2.6–7.6], p <  0.0001), PLR (2 [1.4–3.3] vs 1.9 [1.3–2.9], p = 0.023), NPR (3 [2.1–4.2] vs 2.3 [1.6–3.2], p <  0.0001) and SII (13 [6.5–25.7] vs 9 [4.9–17.5], p <  0.0001) compared to those who did not require ICU admission. After multivariable logistic regression models, NPR was the hemogram-derived ratio with the highest predictive value of ICU admission, (OR 1.11 (95% CI: 0.98–1.22, p = 0.055). Conclusions Simple, hemogram-derived ratios obtained from early hemogram at hospital admission, especially the novelty NPR, have shown to be useful predictors of risk of ICU admission in patients hospitalized due to COVID-19.

A comparative analysis of microscopy and PCR based detection methods for Babesia and Trypanosoma infecting bovines and assessment of risk factors

2018 ◽  
Author(s):  
B. R. Maharana ◽  
B. Kumar ◽  
J. P. Joseph ◽  
T. K. Patbandha
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Regression Models ◽  
Trypanosoma Evansi ◽  
Detection Methods ◽  
Babesia Bigemina ◽  
Multivariate Logistic Regression ◽  
Pcr Assay ◽  
Logistic Regression Models ◽  
The Status

The present study was carried out to evaluate and compare the status of infection and assessment of risk factors in 353 blood samples (144 cattle and 209 buffaloes) of bovines by PCR assay along with microscopic examinations (ME). ME revealed prevalence of Babesia bigemina and Trypanosoma evansi to be 22.91% and 0.69%, respectively in cattle and 12.44% and 0.95%, respectively in buffaloes. Conversely, PCR assay was able to detect 40.97% and 3.47 % prevalence of B. bigemina and T. evansi in cattle and 23.92% and 6.69% in buffaloes, respectively. The result revealed that the PCR assay was 100% sensitive and 82.9% specific when compared with ME for babesiosis and 100% sensitive and 95.42% specific for trypanosomosis. Multivariate logistic regression models showed that risk of babesiosis was significantly higher in cattle (Odds ratio (OR) =2.207, P=0.001) compared to buffaloes. The risk for surra in male buffaloes increased by 6.37 times (OR= 6.375, P=0.013). Conversely, risk of babesiosis was significantly lower in male cattle than females (OR= 0.467, P=0.044).

Demographic factors associated with missed follow-up among solid tumor patients treated at a large multi-site academic institution

2020 ◽  
Vol 16 (32) ◽  
pp. 2635-2643
Author(s):  
Samantha L Freije ◽  
Jordan A Holmes ◽  
Saleh Rachidi ◽  
Susannah G Ellsworth ◽  
Richard C Zellars ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Odds Ratio ◽  
Regression Models ◽  
Tumor Patients ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Follow Up Care ◽  
Risk Patients ◽  
African American Race

Aim: To identify demographic predictors of patients who miss oncology follow-up, considering that missed follow-up has not been well studies in cancer patients. Methods: Patients with solid tumors diagnosed from 2007 to 2016 were analyzed (n = 16,080). Univariate and multivariable logistic regression models were constructed to examine predictors of missed follow-up. Results: Our study revealed that 21.2% of patients missed ≥1 follow-up appointment. African–American race (odds ratio [OR] 1.33; 95% CI: 1.17–1.51), Medicaid insurance (OR 1.59; 1.36–1.87), no insurance (OR 1.66; 1.32–2.10) and rural residence (OR 1.78; 1.49–2.13) were associated with missed follow-up. Conclusion: Many cancer patients miss follow-up, and inadequate follow-up may influence cancer outcomes. Further research is needed on how to address disparities in follow-up care in high-risk patients.

scholarly journals Risk factors for mortality, ICU admission and bacteremia in patients suspected of sepsis at the Emergency department. A prospective cohort study

2020 ◽  
Author(s):  
Valentino D’Onofrio ◽  
Agnes Meersman ◽  
Sara Vijgen ◽  
Reinoud Cartuyvels ◽  
Peter Messiaen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Regression Models ◽  
Serum Lactate ◽  
Suspected Sepsis ◽  
Logistic Regression Models ◽  
Icu Admission ◽  
Observational Cohort ◽  
Independent Risk Factors ◽  
Prediction Of Prognosis

Abstract Background There is a clear need for a better assessment of independent risk factors for in-hospital mortality, ICU admission, and bacteremia in patients presenting with suspected sepsis at the ED. Methods A prospective observational cohort study including 1690 patients was performed. Two multivariable logistic regression models were used to identify independent risk factors. Results SOFA score of ≥2 and serum lactate of ≥2mmol/L were associated with all outcomes. Other independent risk factors were individual SOFA variables and SIRS variables but varied per outcome. MAP&lt;70 mmHg negatively impacted all outcomes. Conclusion These readily available measurements can help with early risk stratification and prediction of prognosis.

scholarly journals Sex Differences in the Association between Internet Usage and Overweight/Obesity: Evidence from a Nationally Representative Survey in Nepal

Sexes ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 132-143
Author(s):  
Juwel Rana ◽  
Md. Momin Islam ◽  
John Oldroyd ◽  
Nandeeta Samad ◽  
Rakibul Islam
Keyword(s):  
Odds Ratio ◽  
Regression Models ◽  
Internet Use ◽  
Adjusted Odds Ratio ◽  
Internet Usage ◽  
The Internet ◽  
Logistic Regression Models ◽  
Biological Sex ◽  
Obesity Interventions ◽  
Nationally Representative

Objective: To examine the associations between internet use and overweight/obesity in people aged 15–49 years in Nepal and the extent to which these associations differ by biological sex. Materials and methods: The study analyzed the nationally representative Nepal Demographic and Health Survey (NDHS) 2016 data. Multivariable ordinal logistic regression models were fitted to estimate the total effects of internet use (IU) in the last 12 months and frequency of internet use (FIU) in the last month on overweight/obesity adjusted for potential confounders. Results: Of the 10,380 participants, the prevalence of overweight/obesity by IU was 38% (95% confidence interval (CI): 35.9%, 40.1%) for males and 44.1% (95% CI: 41.6%, 46.6%) for female. The likelihood of overweight/obesity was significantly higher (adjusted odds ratio (aOR): 1.55; 95% CI: 1.40, 1.73; p < 0.001) among those participants who used the internet compared to the participants who did not use the internet in the last 12 months. Similar associations were observed when using the augmented measure of exposure-FIU in the last month. We observed the modification effect of sex in the associations of IU (p-difference < 0.001) and FIU (p-difference < 0.002) with overweight/obesity in Nepal. Conclusions: Our findings suggest that future overweight/obesity interventions in Nepal discourage unnecessary internet use, particularly among males.

Child awareness of and access to cigarettes: impacts of the point-of-sale display ban in England

2018 ◽  
Vol 28 (5) ◽  
pp. 526-531 ◽  
Author(s):  
Anthony A Laverty ◽  
Eszter Panna Vamos ◽  
Christopher Millett ◽  
Kiara C-M Chang ◽  
Filippos T Filippidis ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Drug Use ◽  
Regression Models ◽  
Multivariate Logistic Regression ◽  
Tobacco Advertising ◽  
Point Of Sale ◽  
Logistic Regression Models ◽  
Annual Survey ◽  
Perceived Difficulty ◽  
Ease Of Access

IntroductionEngland introduced a tobacco display ban for shops with >280 m2 floor area (‘partial ban’) in 2012, then a total ban in 2015. This study assessed whether these were linked to child awareness of and access to cigarettes.MethodsData come from the Smoking, Drinking and Drug Use survey, an annual survey of children aged 11–15 years for 2010–2014 and 2016. Multivariate logistic regression models assessed changes in having seen cigarettes on display, usual sources and ease of access to cigarettes in shopsResultsDuring the partial display ban in 2012, 89.9% of children reported seeing cigarettes on display in the last year, which was reduced to 86.0% in 2016 after the total ban (adjusted OR 0.58, 95% CI 0.50 to 0.66). Reductions were similar in small shops (84.1% to 79.3%)%) and supermarkets (62.6% to 57.3%)%). Although the ban was associated with a reduction in the proportion of regular child smokers reporting that they bought cigarettes in shops (57.0% in 2010 to 39.8% in 2016), we did not find evidence of changes in perceived difficulty or being refused sale among those who still did.DiscussionTobacco point-of-sale display bans in England reduced the exposure of children to cigarettes in shops and coincided with a decrease in buying cigarettes in shops. However, children do not report increased difficulty in obtaining cigarettes from shops, highlighting the need for additional measures to tackle tobacco advertising, stronger enforcement of existing laws and measures such as licencing for tobacco retailers.

scholarly journals Preoperative Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Mean Platelet Volume as Predictors of 1-Year Mortality in Patients Undergoing an Open Repair of Abdominal Aortic Aneurysms: A Retrospective Study

2021 ◽  
Vol 10 (22) ◽  
pp. 5410
Author(s):  
Da Eun Ko ◽  
Hei Jin Yoon ◽  
Sang Beom Nam ◽  
Suk Won Song ◽  
Gisong Lee ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Subgroup Analysis ◽  
Mean Platelet Volume ◽  
Odds Ratio ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet Volume ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Survivor Group ◽  
Abdominal Aortic

Objectives: To investigate if preoperative neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), or mean platelet volume (MPV) could be used to predict 1-year mortality in patients undergoing open abdominal aortic aneurysm (AAA) repair. Methods: We retrospectively reviewed 382 patients who underwent open AAA repair between January 2008 and July 2019. We divided the patients into two groups based on 1-year mortality and compared the preoperative NLR, PLR, and MPV. The patients were then classified into tertiles based on their preoperative NLR (first tertile: < 2.41 (n = 111); second tertile: 2.41 ≤ NLR ≤6.07 (n = 111); and third tertile: > 6.07 (n = 112)). We compared the incidence of mortality and morbidity across the aforementioned tertiles. We performed a stepwise logistic regression analysis to evaluate the predictors for mortality. An additional subgroup analysis was performed by dividing the cases into non-ruptured and ruptured cases. Results: The preoperative NLR was significantly higher in the non-survivor group than in the survivor group (10.53 ± 7.60 vs. 5.76 ± 6.44, respectively, p = 0.003). The PLR and MPV were similar between the groups (145.35 ± 91.11 vs. 154.20 ± 113.19, p = 0.626, 9.38 ± 1.20 vs. 9.11 ± 1.39, p = 0.267, respectively). The incidence of 1-year mortality was 2.7%, 9.0%, and 14.3% in the first, second, and third NLR tertiles, respectively (p = 0.009). Higher NLR (odds ratio 1.085, 95% confidence interval 1.016–1.159, p = 0.015) and ruptured AAA (odds ratio 2.706, 95% confidence interval 1.097–6.673, p = 0.031) were the independent predictors of 1-year mortality in all patients. Moreover, the preoperative NLR was significantly higher in the ruptured AAA than in the non-ruptured AAA group (11.17 ± 7.90 vs. 4.10 ± 4.75, p < 0.001). In subgroup analysis, preoperative NLR (odds ratio 1.144, 95% confidence interval 1.031–1.271, p = 0.012) and PLR (odds ratio 0.986, 95% confidence interval 16 0.975–0.998, p = 0.017) was an independent predictor for 1-year mortality in ruptured cases. Conclusions: We demonstrated an independent relationship between the preoperative NLR and 1-year mortality in patients undergoing open AAA repair, besides PLR and MPV. Furthermore, the NLR and PLR had predictive power for 1-year mortality in ruptured cases.

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