scholarly journals High Neutrophil-lymphocyte Ratio Is a Prognostic Marker for Mortality in Severe Covid-19 and Is Associated With Elevated Age and Kidney Failure

2021 ◽  
Author(s):  
Heitor Santos ◽  
Felipe Delpino ◽  
Octavio Veloso ◽  
Juliana Freire ◽  
Erlaine Gomes ◽  
...  
Keyword(s):  
Critically Ill ◽  
Prognostic Marker ◽  
Kidney Failure ◽  
Critically Ill Patients ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Crude Model ◽  
Obesity Hypertension

Abstract Neutrophil and lymphocyte ratio (NLR) has emerged as a prognostic marker in intensive care. This study aimed to associate high NLR values with COVID-19-associated diseases and mortality among critically ill patients. A cross-sectional study encompassing 189 critically ill patients with COVID-19 was performed. Crude model and adjusted (1- age; 2- sex; 3- kidney failure, diabetes, obesity, hypertension, sex, and age) modes were used. Participants with NLR ≥10.6 were older than those with NLR <10.6 (p < 0.001). The number of deaths (37 vs. 18, p = 0.001) and patients with kidney failure (30 vs. 20, p = 0.045) were higher for NLR ≥10.6 than NLR <10.6. NLR ≥10.6 was associated with higher number of deaths for the crude model (OR: 3.10 [95%CI:1.60-6.01], p = 0.001), age-adjusted (OR: 2.62 [95%CI:1.32-5.20], p = 0.006) and sex-adjusted (OR: 2.97 [95%CI:1.52-5.78], p = 0.031), as well as in the fully-adjusted model (OR: 2.48 [95%CI:1.21-5.08], p = 0.013), when compared to NLR <10.6. Older adults (≥60y) had an OR of 2.61 (95%CI:1.26-5.39, p = 0.010) for mortality compared to adults (≤59y), and the same value was found for the model adjusted for sex (OR: 2.61 [95%CI:1.26-5.42], p = 0.010). Kidney failure was associated with mortality for the crude model (OR: 2.58 [95%CI:1.30-5.11], p = 0.007), age-adjusted (OR: 2.09 [95%CI:1.02-4.27], p = 0.044), and sex-adjusted (OR: 2.45 [95%CI:1.23-4.89], p = 0.011). In conclusion, high NLR is a prognostic marker for mortality in severe COVID-19 and is associated with advanced age and kidney failure.

scholarly journals Varying association of laboratory values with reference ranges and outcomes in critically ill patients: an analysis of data from five databases in four countries across Asia, Europe and North America

2021 ◽  
Vol 28 (1) ◽  
pp. e100419
Author(s):  
Haoran Xu ◽  
Louis Agha-Mir-Salim ◽  
Zachary O’Brien ◽  
Dora C Huang ◽  
Peiyao Li ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Cross Sectional Study ◽  
Specific Reference ◽  
Reference Ranges ◽  
Cross Sectional ◽  
Laboratory Values ◽  
Laboratory Results ◽  
The Usa

BackgroundDespite wide usage across all areas of medicine, it is uncertain how useful standard reference ranges of laboratory values are for critically ill patients.ObjectivesThe aim of this study is to assess the distributions of standard laboratory measurements in more than 330 selected intensive care units (ICUs) across the USA, Amsterdam, Beijing and Tarragona; compare differences and similarities across different geographical locations and evaluate how they may be associated with differences in length of stay (LOS) and mortality in the ICU.MethodsA multi-centre, retrospective, cross-sectional study of data from five databases for adult patients first admitted to an ICU between 2001 and 2019 was conducted. The included databases contained patient-level data regarding demographics, interventions, clinical outcomes and laboratory results. Kernel density estimation functions were applied to the distributions of laboratory tests, and the overlapping coefficient and Cohen standardised mean difference were used to quantify differences in these distributions.ResultsThe 259 382 patients studied across five databases in four countries showed a high degree of heterogeneity with regard to demographics, case mix, interventions and outcomes. A high level of divergence in the studied laboratory results (creatinine, haemoglobin, lactate, sodium) from the locally used reference ranges was observed, even when stratified by outcome.ConclusionStandardised reference ranges have limited relevance to ICU patients across a range of geographies. The development of context-specific reference ranges, especially as it relates to clinical outcomes like LOS and mortality, may be more useful to clinicians.

scholarly journals Erratum for Manuscript “Study On Neutrophil Lymphocyte Ratio And Platelet Lymphocyte Ratio In COVID-19 From Our Prospective. A Cross Sectional Study

2021 ◽  
Vol 9 (1) ◽  
pp. 87-87
Keyword(s):  
Assistant Professor ◽  
Cross Sectional Study ◽  
Associate Professor ◽  
Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Correct Sequence

n the article entitled “Study on Neutrophil Lymphocyte ratio and Platelet lymphocyte ratio in COVID-19 from our prospective -A cross sectional study” published in the Volume 8, Issue 3, September- December 2020 issue of the Perspectives In Medical Research ,[1] the author’s sequence and affiliation is incorrectly written. The correct sequence is as under. 1. Syed Imran Ali, Assistant Professor, Department of Physiology, Mamata Academy of Medical Sciences 2. Farha Tarannum, Assistant Professor, Department of Community medicine, Mamata Academy of Medical Sciences 3. Rubiya Khan, Assistant Professor, Department of Pathology, Mamata Academy of Medical Sciences 4. M Kanya Kumari, Professor, Department of Pathology, Mamata Academy of Medical Sciences 5. Mujahid Mohammed, Associate Professor, Department of Physiology, Mamata Academy of Medical Sciences 6. Mohammed Asghar Ali, Professor, Department of Physiology, Mamata Academy of Medical Sciences Corresponding author: Syed Imran Ali, Assistant Professor, Department of Physiology, Mamata Academy of Medical Sciences

scholarly journals Analysis of oral risk-factors for ventilator-associated pneumonia in critically ill patients

2020 ◽  
Author(s):  
Ademar Takahama ◽  
Vitoria Iaros de Sousa ◽  
Elisa Emi Tanaka ◽  
Evelise Ono ◽  
Fernanda Akemi Nakanishi Ito ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Physical Examination ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Cross Sectional Study ◽  
Ventilator Associated Pneumonia ◽  
Cross Sectional ◽  
Logistic Regression Models

Abstract Objective: This a cross-sectional study to evaluate the association between oral health findings and ventilator-associated pneumonia (VAP) among critically ill patients in intensive care units (ICU). Material and Methods: Data were collected from medical records, and a detailed oral physical examination was performed on 663 critically ill patients on mechanical ventilation. Data were statistically analysed using univariate and logistic regression models relating the development of VAP with the oral findings. Results: At oral physical examination, the most frequent findings were tooth loss (568 - 85.67%), coated tongue (422 - 63.65%) and oral bleeding (192 - 28.96%). Patients with a coated tongue or oral bleeding on the first day of ICU hospitalization developed more VAP than did patients without these conditions (20.14% vs 13.69%: p=0.02; 23.44% vs 15.50%: p=0.01, respectively). In the logistic regression, a coated tongue and oral bleeding were considered independent risk factors for VAP development [OR=1.60 (1.02-2.47) and OR=1.59 (1.05 – 2.44), respectively]. Conclusions: The presence of a coated tongue and oral bleeding in ICU admission could be considered markers for the development of VAP. Clinical relevance: The results of this paper reinforces the importance of proper maintenance of oral hygiene before intubation, which may lead to a decrease in the incidence of VAP in the ICU. This is particularly important in the COVID-19 current scenario, where more people are expected to need mechanical ventilation, consequently increasing cases of VAP.

scholarly journals VALUE OF CLINICAL PULMONARY INFECTION SCORE IN CRITICALLY ILL PATIENTS: BETWEEN THE USE OF CHLORHEXIDINE AND PIPER BETLE LINN MOUTHWASH

2018 ◽  
Vol 4 (1) ◽  
pp. 76-82
Author(s):  
Irfany Nurul Hamid ◽  
Rr Sri Endang Pujiastuti ◽  
Dwi Ari Widigdo ◽  
Djenta Saha
Keyword(s):  
Treatment Group ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pulmonary Infection ◽  
Cross Sectional Study ◽  
Piper Betle ◽  
Ventilator Associated Pneumonia ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean

Background: One of the complications of ventilator use in patients in Intensive Care Unit (ICU) is Ventilator-Associated Pneumonia (VAP). Oral hygienes is one of the methods to prevent VAP.Objective: The objective of this study was to compare the value of clinical infection score (CPIS) in critically ill patients after given oral hygiene using chlorhexidine and Piper betle Linn mouthwash.Methods: This was an observational study with cross-sectional study design, which consisted of two intervention groups. Thirty respondents were selected using total sampling, with 15 respondents randomly assigned in each group. Independent t-test was used for data analysis.Results: Findings showed that  the mean of CPIS in the Piper betle Linn group was 3.80 and the mean of CPIS in the chlorhexidine group was 4.07.Conclusion: CPIS in the treatment group using Piper betle Linn mouthwash was lower than the mean of CPIS in the treatment group using clorhexidine. 

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