Duman Dildar, Sonkaya Esin, Yıldırım Elif, Gıdık Erman, Tanülkü Uğurcan, Saltürk Cüneyt, Karakurt Zuhal
Department of Chest Diseases, University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
Department of Chest Diseases, Gaziosmanpasa Hospital of Yeni Yüzyıl University, İstanbul, Turkey.
Turk Thorac J. 2021 Jan;22(1):24-30. doi: 10.5152/TurkThoracJ.2021.190076. Epub 2021 Jan 1.
Pulmonary embolism (PE) is a serious pathology with high rates of morbidity and mortality. Studies regarding the efficacy of new inflammatory markers as a predictor of mortality in PE have thus far been limited. This study aimed to evaluate the predictive value of platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), platelet/mean platelet volume (PLT/MPV), and C-reactive protein (CRP) on short-term and long-term mortality in patients with PE.
A retrospective, observational cohort study was carried out in a tertiary teaching hospital. Patients with PE hospitalized in the pulmonology ward were enrolled. Their characteristics, hemogram parameters, PLR, NLR, CRP levels, PLT/MPV on admission, and mortality were recorded. The predictive accuracies of inflammatory markers were determined through receiver operating characteristic curves. The risk factors for mortality were further analyzed with Cox regression analysis.
A total of 828 patients with PE were included in the study. The 1-month mortality was 1%, and the 1-year mortality was 8.5%. An NLR value above 6 was associated with an almost 13-fold increase in short-term (30-day) mortality. We found that an NLR above 3.15 and age were independent risk factors for long-term (1-year) mortality. The other inflammatory markers, namely PLR and CRP, were not found to be associated with long-term mortality.
PE is a serious condition in the elderly. Elevated NLR values appear to be a good and feasible predictor of inflammation, which can be correlated with higher mortality over both the short-term and long-term periods.
肺栓塞（PE）是一种具有高发病率和死亡率的严重疾病。迄今为止，关于新型炎症标志物作为PE患者死亡率预测指标有效性的研究有限。本研究旨在评估血小板/淋巴细胞比值（PLR）、中性粒细胞/淋巴细胞比值（NLR）、血小板/平均血小板体积（PLT/MPV）和C反应蛋白（CRP）对PE患者短期和长期死亡率的预测价值。
在一家三级教学医院开展一项回顾性观察队列研究。纳入在呼吸内科病房住院的PE患者。记录他们的特征、血常规参数、PLR、NLR、CRP水平、入院时的PLT/MPV以及死亡率。通过受试者工作特征曲线确定炎症标志物的预测准确性。采用Cox回归分析进一步分析死亡的危险因素。
本研究共纳入828例PE患者。1个月死亡率为1%，1年死亡率为8.5%。NLR值高于6与短期（30天）死亡率几乎增加13倍相关。我们发现NLR高于3.15和年龄是长期（1年）死亡率的独立危险因素。未发现其他炎症标志物，即PLR和CRP，与长期死亡率相关。
PE在老年人中是一种严重疾病。升高的NLR值似乎是炎症的一个良好且可行的预测指标，其与短期和长期更高的死亡率相关。
