中性粒细胞与淋巴细胞比值与伴有血小板减少的严重发热综合征患者 28 天死亡率相关。
Neutrophil-to-lymphocyte ratio is associated with 28-day mortality in patients with severe fever with thrombocytopenia syndrome.
机构信息
Department of Emergency Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
Department of Clinical Laboratory, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
出版信息
BMC Infect Dis. 2022 Mar 6;22(1):225. doi: 10.1186/s12879-022-07206-8.
OBJECTIVES
To determine the association of the neutrophil-to-lymphocyte ratio (NLR) with 28-day mortality in patients with severe fever with thrombocytopenia syndrome (SFTS).
METHODS
A single-centre retrospective analysis was performed in an emergency department from January 01, 2018, to June 30, 2021. Univariate and multivariable Cox proportional hazards regression models were used to investigate the prognostic factors associated with 28-day mortality. Kaplan-Meier curves were analysed in patients stratified by the optimal cut-off point of the NLR determined using a receiver operating characteristic (ROC) curve.
RESULTS
In total, 182 SFTS patients were included, and 24 (13.2%) died within 28 days. The median age of the included patients was 59.64 ± 12.74 years, and 48.4% (88/182) were male. The patients in the non-survival group had significantly higher NLRs than those in the survival group (6.91 ± 6.73 vs. 2.23 ± 1.83). The NLR was a significant predictor of 28-day mortality (adjusted HR: 1.121, 95% CI: 1.033, 1.215). The area under the ROC curve of the NLR for predicting 28-day mortality was 0.743 (95% CI: 0.624, 0.862), and the optimal cut-off value was 4.19 (sensitivity, 54.2%; specificity, 89.2%). In addition, 28-day mortality in the patients with an NLR ≥ 4.19 was notably higher than that in the patients with an NLR < 4.19 (43.3% vs. 7.2%), and Kaplan-Meier analysis showed that the patients with an NLR ≥ 4.19 had a significantly lower survival rate than those with an NLR < 4.19.
CONCLUSIONS
The NLR was a significant, independent predictor of 28-day mortality in SFTS patients.
目的
确定中性粒细胞与淋巴细胞比值（NLR）与严重发热伴血小板减少综合征（SFTS）患者 28 天死亡率的相关性。
方法
对 2018 年 1 月 1 日至 2021 年 6 月 30 日期间在急诊科进行的一项单中心回顾性分析。使用单变量和多变量 Cox 比例风险回归模型来研究与 28 天死亡率相关的预后因素。使用受试者工作特征（ROC）曲线确定 NLR 的最佳截断点，对 NLR 分层的患者进行 Kaplan-Meier 曲线分析。
结果
共纳入 182 例 SFTS 患者，其中 24 例（13.2%）在 28 天内死亡。纳入患者的中位年龄为 59.64±12.74 岁，48.4%（88/182）为男性。非生存组的 NLR 明显高于生存组（6.91±6.73 vs. 2.23±1.83）。NLR 是 28 天死亡率的显著预测因子（调整后的 HR：1.121，95%CI：1.033，1.215）。NLR 预测 28 天死亡率的 ROC 曲线下面积为 0.743（95%CI：0.624，0.862），最佳截断值为 4.19（灵敏度，54.2%；特异性，89.2%）。此外，NLR≥4.19 的患者 28 天死亡率明显高于 NLR<4.19 的患者（43.3% vs. 7.2%），Kaplan-Meier 分析表明，NLR≥4.19 的患者生存率明显低于 NLR<4.19 的患者。
结论
NLR 是 SFTS 患者 28 天死亡率的一个重要、独立的预测因子。
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