Department of Anesthesiology, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
Department of Cardiac Surgery, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
Sci Rep. 2022 Jan 11;12(1):542. doi: 10.1038/s41598-021-04519-7.
The use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasing, but mortality remains high. Early assessment of prognosis is challenging and valid markers are lacking. This study aimed to investigate Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte-Ratio (PLR) and Procalcitonin (PCT) for early assessment of prognosis in patients undergoing VA-ECMO. This retrospective single-center cohort study included 344 consecutive patients ≥ 18 years who underwent VA-ECMO due to cardiogenic shock. Main exposures were NLR, PLR and PCT measured within 24 h after VA-ECMO initiation. The primary endpoint was all-cause in-hospital mortality. In total, 92 patients were included into final analysis (71.7% male, age 57 ± 14 years). In-hospital mortality rate was 48.9%. Receiver operating characteristics (ROC) curve revealed an area under the curve (AUC) of 0.65 [95% confidence interval (CI) 0.53-0.76] for NLR. The AUCs of PLR and PCT were 0.47 [95%CI 0.35-0.59] and 0.54 [95%CI 0.42-0.66], respectively. Binary logistic regression showed an adjusted odds ratio of 3.32 [95%CI 1.13-9.76] for NLR, 1.0 [95%CI 0.998-1.002] for PLR and 1.02 [95%CI 0.99-1.05] for PCT. NLR is independently associated with in-hospital mortality in patients undergoing VA-ECMO. However, discriminative ability is weak. PLR and PCT seem not to be suitable for this purpose.
体外膜肺氧合（VA-ECMO）的应用正在增加，但死亡率仍然很高。预后的早期评估具有挑战性，且缺乏有效的标志物。本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和降钙素原（PCT）在 VA-ECMO 患者预后早期评估中的作用。这是一项回顾性单中心队列研究，纳入了 344 名因心源性休克而接受 VA-ECMO 的连续患者（年龄≥18 岁）。主要暴露因素为 VA-ECMO 启动后 24 小时内测量的 NLR、PLR 和 PCT。主要终点是全因住院死亡率。共有 92 例患者纳入最终分析（71.7%为男性，年龄 57±14 岁）。住院死亡率为 48.9%。接受者操作特征（ROC）曲线显示 NLR 的曲线下面积（AUC）为 0.65[95%置信区间（CI）0.53-0.76]。PLR 和 PCT 的 AUC 分别为 0.47[95%CI 0.35-0.59]和 0.54[95%CI 0.42-0.66]。二元逻辑回归显示 NLR 的调整比值比为 3.32[95%CI 1.13-9.76]，PLR 为 1.0[95%CI 0.998-1.002]，PCT 为 1.02[95%CI 0.99-1.05]。NLR 与 VA-ECMO 患者的住院死亡率独立相关，但区分能力较弱。PLR 和 PCT 似乎不适合用于此目的。
