Wang Xue, Wang Jie, Wu Shujie, Ni Qingwei, Chen Peng
Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China.
Int J Gen Med. 2021 Aug 28;14:4933-4943. doi: 10.2147/IJGM.S328882. eCollection 2021.
The neutrophil percentage-to-albumin ratio (NPAR) is a systemic inflammation-based predictor associated with many diseases' outcomes. Nevertheless, there are few studies on the relationship between NPAR and inflammatory markers, and more importantly, the prognostic value of NPAR in critically ill patients with cardiovascular disease (CVD) remains unknown.
The data of this retrospective cohort study were from the Medical Information Mart data for Intensive Care III database (MIMIC-III) and the Second Affiliated Hospital of Wenzhou Medical University. Linear regression, logistic regression model, and Cox regression model were used to assess the associations between NPAR levels and length of stay, renal replacement therapy (RRT) use, and 30-day, 90-day and one-year mortality, respectively. The Pearson correlation coefficient was used to present the correlation between NPAR and C-reactive protein (CRP).
Our study included 1599 patients in MIMIC-III and 143 patients in the Second Affiliated Hospital of Wenzhou Medical University. The elevated NPAR was independently associated with increased 30-day, 90-day, and one-year all-cause mortality (adjusted HR, 95% CI:1.51 (1.02-2.24); 1.61 (1.14-2.28); 1.53 (1.15-2.03); trend = 0.0297; 0.0053; 0.0023; respectively), and it was also associated with increase the length of stay in hospital and ICU (β, 95% CI: 2.76 (1.26-4.27); 1.54 (0.62-2.47), respectively, both trend <0.001). We found that patients with higher NPAR were more likely to receive RRT (OR, 95% CI: 2.50 (1.28-4.89), trend =0.0023). Moreover, we confirmed that NPAR was statistically positively correlated with CRP (correlation coefficient r = 0.406, < 0.0001).
Elevated NPAR on admission was independently associated with increased all-cause mortality and length of stay among CICU patients. The results showed that CICU patients with higher NPAR were more likely to receive RRT. Besides, we also provided the evidence that there is a positive correlation between NPAR and inflammatory indicators (ie, CRP).
中性粒细胞百分比与白蛋白比值（NPAR）是一种基于全身炎症的预测指标，与多种疾病的预后相关。然而，关于NPAR与炎症标志物之间关系的研究较少，更重要的是，NPAR在重症心血管疾病（CVD）患者中的预后价值仍不清楚。
这项回顾性队列研究的数据来自重症监护医学信息集市数据库三期（MIMIC-III）和温州医科大学附属第二医院。分别采用线性回归、逻辑回归模型和Cox回归模型评估NPAR水平与住院时间、肾脏替代治疗（RRT）使用情况以及30天、90天和1年死亡率之间的关联。采用Pearson相关系数来表示NPAR与C反应蛋白（CRP）之间的相关性。
我们的研究纳入了MIMIC-III中的1599例患者和温州医科大学附属第二医院的143例患者。NPAR升高与30天、90天和1年全因死亡率增加独立相关（调整后的HR，95%CI：1.51（1.02-2.24）；1.61（1.14-2.28）；1.53（1.15-2.03）；趋势分别为0.0297；0.0053；0.0023），并且还与住院时间和重症监护病房（ICU）住院时间延长相关（β，95%CI：分别为2.76（1.26-4.27）；1.54（0.62-2.47），两者趋势均<0.001）。我们发现NPAR较高的患者更有可能接受RRT（OR，95%CI：2.50（1.28-4.89），趋势=0.0023）。此外，我们证实NPAR与CRP在统计学上呈正相关（相关系数r = 0.406，<0.0001）。
入院时NPAR升高与心血管重症监护病房（CICU）患者全因死亡率增加和住院时间延长独立相关。结果表明，NPAR较高的CICU患者更有可能接受RRT。此外，我们还提供了证据表明NPAR与炎症指标（即CRP）之间存在正相关。
