Ozmen I, Karakurt Z, Salturk C, Kargin F, Takir H B, Aksoy E, Sari R, Celik E, Tuncay E A, Yildirim E, Mocin O Y, Adiguzel N, Oztas S, Gungor S, Gungor G
Bratisl Lek Listy. 2016;117(10):587-594. doi: 10.4149/bll_2016_114.
There is limited data about ICU, short and long-term mortality prediction of severe CAP with neutrophil-to-lymphocyte ratio (NLR): N-terminal proB- type natriuretic peptide (NT-proBNP): C-reactive protein (CRP).
Besides the known severity indexes of ICU, can NLR, NT-proBNP, CRP predict ICU, short and long term mortality?
A retrospective cohort study was carried out in a level III ICU of a tertiary training hospital for chest diseases and thoracic surgery.
Over the study period, a total of 143 patients were enrolled in the study. The APACHE II scoring showed a significantly higher predicting performance for ICU mortality (p = 0.002). The performance for predicting short term mortality NLR (p = 0.039) and long term mortality NTproBNP (p = 0.002) had a significantly higher performance. The survival analysis revealed that mortality was significantly higher in patients with CURB65 score ≥ 4 (p = 0.047).
NLR, NTproBNP > 2000pg/mL can be used to predict pneumonia severity in ICU alike CURB65 and PSI. Higher NLR, APACHE II and atrial fibrillation can cause an important mortality factor in long term. Consequently, clinicians should take an attention for good cardiac evaluation and cardiac follow-up of patients with CAP (Tab. 4, Fig. 3, Ref. 36).
关于重症社区获得性肺炎(CAP)的中性粒细胞与淋巴细胞比值(NLR)、N末端B型脑钠肽原(NT-proBNP)、C反应蛋白(CRP)对重症监护病房(ICU)短期和长期死亡率预测的数据有限。
除了已知的ICU严重程度指标外,NLR、NT-proBNP、CRP能否预测ICU短期和长期死亡率?
在一家三级胸科疾病和胸外科培训医院的三级ICU进行了一项回顾性队列研究。
在研究期间,共有143例患者纳入研究。急性生理与慢性健康状况评分系统(APACHE II)评分对ICU死亡率的预测性能显著更高(p = 0.002)。NLR对短期死亡率的预测性能(p = 0.039)和NT-proBNP对长期死亡率的预测性能(p = 0.002)显著更高。生存分析显示,CURB65评分≥4的患者死亡率显著更高(p = 0.047)。
NLR、NT-proBNP>2000pg/mL可用于预测ICU中肺炎的严重程度,类似于CURB65和肺炎严重指数(PSI)。较高的NLR、APACHE II评分和心房颤动可导致长期重要的死亡因素。因此,临床医生应重视对CAP患者进行良好的心脏评估和心脏随访(表4,图3,参考文献36)。