scholarly journals Baseline Neutrophil-to-Lymphocyte Ratio Is Independently Associated With 90-Day Transplant-Free Mortality in Patients With Cirrhosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jing Liu ◽  
Hai Li ◽  
Jie Xia ◽  
Xianbo Wang ◽  
Yan Huang ◽  
...  
Keyword(s):  
Cubic Splines ◽  
Neutrophil To Lymphocyte Ratio ◽  
Short Term ◽  
Infection Group ◽  
Lymphocyte Ratio ◽  
Increased Risk ◽  
Unit Increase ◽  
Short Term Mortality ◽  
Cirrhotic Patients ◽  
Restricted Cubic Splines

Background: Patients with cirrhosis have an increased risk of short-term mortality, however, few studies quantify the association between neutrophil-to-lymphocyte ratio (NLR) and 90-day transplant-free mortality in cirrhotic patients.Methods: We prospectively analyzed 3,970 patients with chronic liver diseases from two multicenter cohorts in China (January 2015 to December 2016 and July 2018 to January 2019). Restricted cubic splines (RCS) were used to analyze the relation of NLR and all-causes 90-day transplant-free mortality in cirrhosis.Results: A total of 2,583 cirrhotic patients were enrolled in our study. Restricted cubic splines showed that the odds ratio (OR) of all causes 90-day transplant-free mortality started to increase rapidly until around NLR 6.5, and then was relatively flat (p for non-linearity <0.001). The risk of 90-day transplant-free mortality in cirrhotic patients with NLR < 6.5 increased with an increment of 23% for every unit increase in NLR (p < 0.001). The patients with NLR < 4.5 had the highest risk (OR: 2.34, 95% CI 1.66–3.28). In multivariable-adjusted stratified analyses, the increase in the incidence of 90-day transplant-free mortality with NLR increasing was consistent (OR >1.0) across all major prespecified subgroups, including infection group (OR: 1.04, 95% CI 1.00–1.09) and non-infection (OR: 1.06, 95% CI 1.02–1.11) group. The trends for NLR and numbers of patients with organ failure varied synchronously and were significantly increased with time from day 7 to day 28.Conclusions: We found a non-linear association between baseline NLR and the adjusted probability of 90-day transplant-free mortality. A certain range of NLR is closely associated with poor short-term prognosis in patients with cirrhosis.

scholarly journals Prognostic Value of Neutrophil to Lymphocyte Ratio and Risk Factors for Mortality in Patients with Stanford Type A Aortic Dissection

2017 ◽  
Vol 20 (3) ◽  
pp. 119 ◽  
Author(s):  
Kursad Oz ◽  
Taner Iyigun ◽  
Zeynep Karaman ◽  
Ömer Çelik ◽  
Ertan Akbay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Aortic Dissection ◽  
Neutrophil To Lymphocyte Ratio ◽  
Control Group ◽  
Operating Characteristics ◽  
Short Term ◽  
Lymphocyte Ratio ◽  
Wide Range ◽  
Short Term Mortality

Background: Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of cardiovascular disease. Acute aortic dissection (AD) is an uncommon but fatal cardiovascular disease. In this study, we investigated both prognostic factors in patients with AD and whether NLR can be a predictor for mortality. Methods: We analyzed retrospectively the data of 57 patients with AD who had undergone emergent surgery in our hospital and included 128 consecutive patients with chest pain admitted to the emergency room as a control group. Also, patients who were operated on due to aortic dissection as another subgroup were compared to NLR values. Baseline clinical features, cardiovascular risk factors, and surgical and laboratory parameters were obtained from the hospital database. Results: Patients with AD had higher NLR than the control group (1.7 ± 0.5 versus 7.6 ± 3.3, P < .001). In the AD group, 15 deaths occurred and non-survivors had significantly higher NLR, compared to survivors (11.6 ± 2.4 versus 6.6 ± 2.3, P < .001). In multivariate analysis, high NLR (odds ratio [OR] 1.913, 95% CI 1.030-1.081, P = .04) and cross-clamp time (OR 1.265, 95% CI 1.003-1.596, P = .04) were determined as independent predictors of in-hospital mortality. In receiver operating characteristics curve analyses, the NLR > 9.3 predicted the mortality in AD with a specificity of 91% and a sensitivity of 86% (P < .001).Conclusion: This study shows that high NLR can be used as a marker for prognosis in short-term mortality of patient with AD. Additionally, increased lactate level in perioperative period, prolonged cardiopulmonary bypass time, and additional cardiac procedures are strong independent predictors of short-term mortality in patients with acute AD.

scholarly journals Neutrophil to lymphocyte ratio in predicting short-term mortality in hemodialysis patients

2013 ◽  
Vol 30 (2) ◽  
pp. 129-132 ◽  
Author(s):  
Emre Erdem ◽  
Coşkun Kaya ◽  
Ahmet Karataş ◽  
Melda Dilek ◽  
Tekin Akpolat
Keyword(s):  
Hemodialysis Patients ◽  
Neutrophil To Lymphocyte Ratio ◽  
Short Term ◽  
Lymphocyte Ratio ◽  
Short Term Mortality

scholarly journals Neutrophil-to-Lymphocyte Ratio and Albumin: New Serum Biomarkers to Predict the Prognosis of Male Alcoholic Cirrhosis Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Mingyuan Zhang ◽  
Yu Zhang ◽  
Lili Liu ◽  
Mozumder Prithweeraj ◽  
Hongqin Xu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Liver Disease ◽  
Roc Curve ◽  
Alcoholic Cirrhosis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Prognostic Scores ◽  
Patient Death ◽  
Short Term ◽  
Lymphocyte Ratio ◽  
Short Term Mortality

Background and Aims. Alcohol-associated liver disease is exhibiting an increasing disease burden. In terms of pathogenesis, inflammation is closely related to alcohol-induced liver injury. The neutrophil-to-lymphocyte ratio (NLR) is a novel inflammatory biomarker. Here, we aim to evaluate the role of the NLR and other biomarkers in predicting short-term mortality in alcoholic cirrhotic patients. Methods. This was a retrospective study that included 459 male alcoholic cirrhosis patients. Among them, 345 patients completed follow-up. Based on their 30-day mortality information, patients were separated into surviving and nonsurviving groups. Demographic, clinical, and biochemical features were collected for further analysis. Logistic regression was used to identify factors associated with short-term mortality, and receiver operating characteristic (ROC) curve analysis was used to establish the predictive value of these factors. Results. The prognostic scores were significantly higher in the nonsurviving group than in the surviving group: NLR: 5.5 vs. 3.2 ( P < 0.001 ), model for end-stage liver disease (MELD): 15.4 vs. 7.9 ( P < 0.001 ), Maddrey’s discriminant function (MDF): 39.8 vs. 12.7 ( P < 0.001 ), and the integrated MELD (i-MELD): 37.9 vs. 28.4 ( P < 0.001 ). Logistic regression demonstrated that albumin (ALB), NLR, and i-MELD values were significantly correlated with patient death in 30 days. On ROC analysis, the diagnostic accuracy for 30-day mortality of the NLR (area under the ROC curve (AUROC) of 0.72, P < 0.001 ) was similar to that of the MELD or i-MELD (AUROCs of 0.71 and 0.74, respectively, P < 0.001 ). The new biomarker, NLA, calculated as 100 × NLR / ALB , had the best prognostic value. The cutoff values of the NLR and NLA for predicting 30-day mortality were 4.2 and 19.6, respectively. Conclusions. The NLR and its related biomarker NLA are simple and robust predictors of 30-day mortality in alcoholic cirrhosis patients.

scholarly journals Role of circulatory leukocyte based indices in short-term mortality of patients with heart failure with reduced ejection fraction

2020 ◽  
Author(s):  
Mohammadreza Taban Sadeghi ◽  
Ilqhar Esgandarian ◽  
Masoud Nouri-Vaskeh ◽  
Ali Golmohammadi ◽  
Negin Rahvar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Lymphocyte Count ◽  
Neutrophil To Lymphocyte Ratio ◽  
Short Term ◽  
Reduced Ejection Fraction ◽  
Lymphocyte Ratio ◽  
Patients With Heart Failure ◽  
Short Term Mortality

Background. Pro-inflammatory signaling is mediated by a variety of inflammatory mediators which can cause myocardial apoptosis, hypertrophia, and fibrosis, and also ultimately lead to adverse cardiac remodeling. This study aimed to assess the role of circulating leukocyte-based indices in predicting the short-term mortality in patients with heart failure with reduced ejection fraction (HFrEF). Methods. In a retrospective study, patients with HFrEF admitted to a tertiary referral center between January 2016 and January 2017 were recruited to this study. The association between neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dLNR = neutrophils/(leukocytes-neutrophils)), monocyte/granulocyte to lymphocyte ratio (MGLR = (white cell count-lymphocyte count) to lymphocyte count), platelet to lymphocyte ratio (PLR) and six-months mortality of patients were assessed. Results. A total of 197 patients with HFrEF were enrolled in the study. NLR (P<0.001), dNLR (P<0.001), MGLR (P<0.001), PLR (P=0.006) and LVEF (P=0.042) showed significant difference between survived and died patients. In the Cox multivariate analysis we did not find NLR, dLNR, MGLR or PLR as an independent predictor of short-term mortality in HFrEF patients. Conclusions. Although High NLR, PLR, MGLR and dNLR was associated with short-term mortality, it failed to independently predict the prognosis of HFrEF patients.

Impact of Baseline Neutrophil-to-Lymphocyte Ratio on Long-Term Prognosis in Patients With Atrial Fibrillation

Angiology ◽  
2021 ◽  
pp. 000331972110004
Author(s):  
Shuang Wu ◽  
Yan-min Yang ◽  
Jun Zhu ◽  
Jia-meng Ren ◽  
Juan Wang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Continuous Variable ◽  
Cox Proportional Hazards ◽  
Neutrophil To Lymphocyte Ratio ◽  
Long Term Outcomes ◽  
Lymphocyte Ratio ◽  
Net Reclassification Improvement ◽  
Increased Risk ◽  
All Cause Mortality

We performed a retrospective analysis involving 1269 patients with atrial fibrillation (AF) to evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) on long-term outcomes. The primary outcomes were all-cause mortality and combined end point events (CEEs). Cox proportional hazards regression analysis and net reclassification improvement (NRI) analysis were performed. During a median follow-up of 3.32 years, 285 deaths and 376 CEEs occurred. With the elevation of the NLR, the incidence of all-cause mortality (2.77, 4.14, 6.12, and 12.18/100 person-years) and CEEs (4.19, 7.40, 8.03, and 15.22/100 person-years) significantly increased. Multivariate Cox analysis indicated that the highest NLR quartile was independently associated with the incidence of all-cause mortality (hazard ratio [HR] = 1.77, 95% CI: 1.19-2.65) and CEEs (HR = 1.66, 95% CI: 1.18-2.33). When the NLR was analyzed as a continuous variable, a 1-unit increment in log NLR was related to 134% increased risk of all-cause mortality and 119% increased risk of CEEs. Net reclassification improvement analysis revealed that NLR significantly improved risk stratification for all-cause death and CEEs by 15.0% and 9.6%, respectively. Neutrophil-to-lymphocyte ratio could be an independent predictor of long-term outcomes in patients with AF.

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