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中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值及预后标志物对重症监护病房中诊断为肺炎患者死亡率的影响

The Effects of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Prognostic Markers in Determining the Mortality in Patients Diagnosed With Pneumonia in Intensive Care.

作者信息

Altas Omer Faruk, Kizilkaya Mehmet

机构信息

Izmir Bakircay University Cigli Training and Research Hospital, Department of Anesthesiology and Reanimation, Izmir, Turkey.

Amasya University Sabuncuoğlu Serafettin Training and Research Hospital, Department of Anesthesiology and Reanimation, Amasya, Turkey.

出版信息

Medeni Med J. 2021;36(2):130-137. doi: 10.5222/MMJ.2021.64160. Epub 2021 Jun 18.

Abstract

OBJECTIVE

In this study, we aimed to reveal the level of predicting mortality of the Neutrophil/Lymphocyte (NLR) and Platelet/Lymphocyte Ratios (TLR) calculated in patients hospitalized with the diagnosis of pneumonia in the intensive care unit when compared with other prognostic scores.

METHOD

The hospital records of 112 patients who were admitted to the intensive care unit between January 2015 and January 2018 and met the inclusion criteria were retrospectively reviewed. The patients' demographic data, the NLR and PLR levels, and the APACHE II (Acute Physiology and Chronic Health Evaluation II) and SOFA (Sequential Organ Failure Assessment) scores were calculated from the patient files.

RESULTS

Of the 112 patients examined, 70 were males. The risk analysis showed that the male gender had 2.7 times higher risk of mortality. The NLR, PLR, APACHE II, and SOFA values were found statistically significant in predicting mortality (p<0.001). An evaluation of the risk ratios demonstrated that each one point increase in the NLR increased the mortality risk by 5%, and each one point increase in the SOFA score increased the mortality risk by 13% (p<0.05). In the ROC (receiver operating characteristic) analysis, the NLR assessment proved to be the most powerful, most specific, and sensitive test. The cut-off values were 11.3 for the NLR, 227 for the PLR, 29.8 for the APACHE II scores, and 5.5 for the SOFA scores.

CONCLUSION

We believe that NLR and PLR are strong and independent predictors of mortality that can be easily and cost-effectively tested.

摘要

目的

在本研究中,我们旨在揭示在重症监护病房因肺炎诊断住院的患者中计算得出的中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)与其他预后评分相比预测死亡率的水平。

方法

回顾性分析2015年1月至2018年1月期间入住重症监护病房且符合纳入标准的112例患者的医院记录。从患者病历中计算患者的人口统计学数据、NLR和PLR水平以及急性生理与慢性健康状况评分系统II(APACHE II)和序贯器官衰竭评估(SOFA)评分。

结果

在检查的112例患者中,70例为男性。风险分析表明,男性的死亡风险高2.7倍。发现NLR、PLR、APACHE II和SOFA值在预测死亡率方面具有统计学意义(p<0.001)。风险比评估表明,NLR每增加1分,死亡风险增加5%,SOFA评分每增加1分,死亡风险增加13%(p<0.05)。在受试者工作特征(ROC)分析中,NLR评估被证明是最有力、最特异和最敏感的测试。NLR的临界值为11.3,PLR为227,APACHE II评分为29.8,SOFA评分为5.5。

结论

我们认为NLR和PLR是死亡率的强大且独立的预测指标,可轻松且经济高效地进行检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71e6/8226410/6295ca52e9c3/MEDJ-36-130-f1.jpg

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