Dadong Liu1, Zongying Yu2, Dehou Zhang1, Jianguo Zhang1, Yafeng Zhang3, Xu Wang4. 1. Department of Intensive Care Unit, Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu, China. 2. Department of Electrocardiograph, the 4th Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu, China. 3. Department of Infection Management, Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu, China. 4. Department of Oncology, Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu, China. Corresponding author: Wang Xu, Email: jsdxwx@126.com.
Abstract
OBJECTIVE: To evaluate the value of neutrophil to lymphocyte and platelet ratio (N/LPR) for predicting 28-day mortality in sepsis patients. METHODS: A retrospective analysis was conducted. The clinical data of 154 sepsis patients admitted to intensive care unit (ICU) of the Affiliated Hospital of Jiangsu University from June 2017 to June 2020 were enrolled. The time of first diagnosis of sepsis in ICU was taken as the research starting point, and the death or 28 days as the end point. The 28-day outcomes of patients were recorded. The counts of peripheral blood neutrophil (NEU), lymphocyte (LYM) and platelet (PLT) were collected from all the enrolled patients within 3 days after diagnosis of sepsis. The ratios of N/LPR and NEU/LYM (NLR) were calculated respectively. The differences of N/LPR and NLR between survival group and death group were compared. Receiver operating characteristic (ROC) curve analysis was used to analyze the value of N/LPR and NLR on predicting the 28-day mortality of sepsis patients. According to the best cut-off value of ROC curve analysis, the 28-day mortality of patients with sepsis was analyzed by subgroup analysis, and the 28-day cumulative survival of patients with sepsis was analyzed by Kaplan-Meier survival curve. RESULTS: Of the 154 sepsis patients, the patients with age < 18 years, pregnancy, blood disease, taking aspirin or other antiplatelet drugs within 1 week, taking leucocyte drugs within 1 week, length of ICU stay < 3 days and incomplete data were excluded. Finally, 50 patients were enrolled. Among them, 30 patients survived on the 28th day and 20 died. Compared with the survival group, the levels of N/LPR and NLR in the death group were significantly increased (N/LPR: 23.85±11.99 vs. 12.41±5.25, NLR: 17.83±8.69 vs. 10.75±3.63), with statistical differences (both P < 0.01). ROC curve analysis indicated that the area under ROC curve (AUC) of N/LPR for predicting 28-day death of sepsis patients was 0.827, it was higher than that of NLR (AUC = 0.762). Base on N/LPR ≥ 15.48 as a predictor of cut-off value of death in 28 days of sepsis patients, the sensitivity was 75.0% and the specificity was 80.0%, respectively. Base on NLR ≥ 10.65 as a predictor of cut-off value of death in 28 days of sepsis patients, the sensitivity was 75.0% and specificity was 56.7%, respectively. Subgroup analysis showed that the 28-day mortality in the patients with N/LPR ≥ 15.48 (n = 21) was significantly higher than those with N/LPR < 15.48 (n = 29; 71.4% vs. 17.2%, χ2 = 14.901, P < 0.01); and the 28-day mortality in the patients with NLR ≥ 10.65 (n = 28) was also significantly higher than those with NLR < 10.65 (n = 22; 53.6% vs. 22.7%, χ2 = 4.884, P < 0.05). The results were consistent with Kaplan-Meier survival curve analysis. CONCLUSIONS: Peripheral blood N/LPR has a good predictive value for 28-day mortality of sepsis patients, and which is better than NLR.
OBJECTIVE: To evaluate the value of neutrophil to lymphocyte and platelet ratio (N/LPR) for predicting 28-day mortality in sepsispatients. METHODS: A retrospective analysis was conducted. The clinical data of 154 sepsispatients admitted to intensive care unit (ICU) of the Affiliated Hospital of Jiangsu University from June 2017 to June 2020 were enrolled. The time of first diagnosis of sepsis in ICU was taken as the research starting point, and the death or 28 days as the end point. The 28-day outcomes of patients were recorded. The counts of peripheral blood neutrophil (NEU), lymphocyte (LYM) and platelet (PLT) were collected from all the enrolled patients within 3 days after diagnosis of sepsis. The ratios of N/LPR and NEU/LYM (NLR) were calculated respectively. The differences of N/LPR and NLR between survival group and death group were compared. Receiver operating characteristic (ROC) curve analysis was used to analyze the value of N/LPR and NLR on predicting the 28-day mortality of sepsispatients. According to the best cut-off value of ROC curve analysis, the 28-day mortality of patients with sepsis was analyzed by subgroup analysis, and the 28-day cumulative survival of patients with sepsis was analyzed by Kaplan-Meier survival curve. RESULTS: Of the 154 sepsispatients, the patients with age < 18 years, pregnancy, blood disease, taking aspirin or other antiplatelet drugs within 1 week, taking leucocyte drugs within 1 week, length of ICU stay < 3 days and incomplete data were excluded. Finally, 50 patients were enrolled. Among them, 30 patients survived on the 28th day and 20 died. Compared with the survival group, the levels of N/LPR and NLR in the death group were significantly increased (N/LPR: 23.85±11.99 vs. 12.41±5.25, NLR: 17.83±8.69 vs. 10.75±3.63), with statistical differences (both P < 0.01). ROC curve analysis indicated that the area under ROC curve (AUC) of N/LPR for predicting 28-day death of sepsispatients was 0.827, it was higher than that of NLR (AUC = 0.762). Base on N/LPR ≥ 15.48 as a predictor of cut-off value of death in 28 days of sepsispatients, the sensitivity was 75.0% and the specificity was 80.0%, respectively. Base on NLR ≥ 10.65 as a predictor of cut-off value of death in 28 days of sepsispatients, the sensitivity was 75.0% and specificity was 56.7%, respectively. Subgroup analysis showed that the 28-day mortality in the patients with N/LPR ≥ 15.48 (n = 21) was significantly higher than those with N/LPR < 15.48 (n = 29; 71.4% vs. 17.2%, χ2 = 14.901, P < 0.01); and the 28-day mortality in the patients with NLR ≥ 10.65 (n = 28) was also significantly higher than those with NLR < 10.65 (n = 22; 53.6% vs. 22.7%, χ2 = 4.884, P < 0.05). The results were consistent with Kaplan-Meier survival curve analysis. CONCLUSIONS: Peripheral blood N/LPR has a good predictive value for 28-day mortality of sepsispatients, and which is better than NLR.
Authors: Titus A P de Hond; Gurbey Ocak; Leonie Groeneweg; Jan Jelrik Oosterheert; Saskia Haitjema; Meriem Khairoun; Karin A H Kaasjager Journal: J Clin Med Date: 2022-02-16 Impact factor: 4.241