Turcato Gianni, Sanchis-Gomar Fabian, Cervellin Gianfranco, Zorzi Elisabetta, Sivero Valentina, Salvagno Gian Luca, Tenci Andrea, Lippi Giuseppe
Department of Emergency Medicine, G. Fracastoro Hospital of San Bonifacio, Azienda Ospedaliera Scaligera, San Bonifacio, Verona, Italy.
Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, USA.
J Med Biochem. 2019 Jul 30;38(4):452-460. doi: 10.2478/jomb-2018-0044. eCollection 2019 Oct.
To investigate the association between both neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) and 30-day mortality in patients hospitalized for an episode of acute decompensated heart failure (ADHF).
439 patients admitted to emergency department (ED) for an episode of ADHF. Clinical history, demographic, clinical and laboratory data recorded at ED admission and then correlated with 30-day mortality.
45/439 (10.3%) patients died within 30 days from ED admission. The median values of NLR (4.1 vs 11.7) and PLR (159.1 vs 285.9) were significantly lower in survivors than in patients who died. The area under the ROC curve of NLR was significantly higher than that of the neutrophil count (0.76 vs 0.59; p<0.001), whilst the AUC of PLR was significantly better than that of the platelet count (0.71 vs 0.51; p<0.001). In univariate analysis, both NLR and PLR were significantly associated with 30-day. In the fully-adjusted multivariate model, NLR (odds ratio, 3.63) and PLR (odds ratio, 3.22) remained independently associated with 30-day mortality after ED admission.
Routine assessment of NLR and PLR at ED admission may be a valuable aid to complement other conventional measures for assessing the medium-short risk of ADHF patients.
探讨中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）与因急性失代偿性心力衰竭（ADHF）发作而住院患者30天死亡率之间的关联。
439例因ADHF发作入住急诊科（ED）的患者。记录ED入院时的临床病史、人口统计学、临床和实验室数据，然后将其与30天死亡率进行关联分析。
439例患者中有45例（10.3%）在ED入院后30天内死亡。幸存者的NLR（4.1对11.7）和PLR（159.1对285.9）中位数显著低于死亡患者。NLR的ROC曲线下面积显著高于中性粒细胞计数（0.76对0.59；p<0.001），而PLR的AUC显著优于血小板计数（0.71对0.51；p<0.001）。在单因素分析中，NLR和PLR均与30天死亡率显著相关。在完全调整的多变量模型中，ED入院后NLR（比值比，3.63）和PLR（比值比，3.22）仍与30天死亡率独立相关。
在ED入院时常规评估NLR和PLR可能有助于补充其他传统措施，以评估ADHF患者的中短期风险。
