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淋巴细胞与白细胞比值对感染性心内膜炎患者住院死亡率的预后价值。

Prognostic Value of Lymphocyte-to-White Blood Cell Ratio for In-Hospital Mortality in Infective Endocarditis Patients.

机构信息

Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, China.

出版信息

Int J Clin Pract. 2022 Feb 25;2022:8667054. doi: 10.1155/2022/8667054. eCollection 2022.

Abstract

BACKGROUND

The prognosis of Infective endocarditis (IE) is poor, and we conducted this investigation to evaluate the worth of admission lymphocyte-to-white blood cell ratio (LWR) for prediction of short-term outcome in IE patients.

METHODS

We retrospectively assessed the medical records of 147 IE patients from January 2017 to December 2019. Patients were divided into the survivor group and nonsurvivor group. Univariate and multivariate analyses were applied to estimate the independent factors contribution to in-hospital death, and receiver-operator characteristic (ROC) curve was utilized to check the performance.

RESULTS

The levels of LWR (0.17 ± 0.08 vs. 0.10 ± 0.06) were significantly increased among the survivor group compared with the nonsurvivor group ( = 0.001). Multivariate analysis displayed that LWR (hazard ratio (HR): 1.755, 1.304-2.362,  < 0.001) was not interfered by other confounding factors for early death. Moreover, ROC analysis suggested that LWR (cutoff value = 0.10) performed the best among assessed indexes for the forecast of primary outcome (area under curve (AUC) = 0.750, 95% confidence interval (CI) = 0.634-0.867,  < 0.001, sensitivity = 70.0%, specificity = 76.4%), and the proportion of in-hospital mortality was remarkably inferior in patients with LWR > 0.10 than in those with LWR ≤ 0.10. (5.83% vs. 31.8%,  < 0.001).

CONCLUSIONS

LMR is an independent, simple, universal, inexpensive, and reliable prognostic parameter to identify high-risk IE patients for in-hospital mortality.

摘要

背景

感染性心内膜炎(IE)的预后较差,我们进行此项研究旨在评估入院时淋巴细胞与白细胞比值(LWR)对 IE 患者短期预后的预测价值。

方法

我们回顾性评估了 2017 年 1 月至 2019 年 12 月期间 147 例 IE 患者的病历。患者分为存活组和死亡组。采用单因素和多因素分析来评估导致住院死亡的独立因素,并使用受试者工作特征(ROC)曲线来评估其性能。

结果

与存活组相比,死亡组的 LWR 水平(0.17±0.08 比 0.10±0.06)显著升高( = 0.001)。多因素分析显示,LWR(危险比(HR):1.755,1.304-2.362, < 0.001)不受其他混杂因素的影响,是早期死亡的独立危险因素。此外,ROC 分析表明,在评估的指标中,LWR(截断值=0.10)对主要结局的预测效果最佳(曲线下面积(AUC)=0.750,95%置信区间(CI)=0.634-0.867, < 0.001,敏感性=70.0%,特异性=76.4%),且 LWR>0.10 的患者住院死亡率明显低于 LWR≤0.10 的患者(5.83%比 31.8%, < 0.001)。

结论

LMR 是一种独立、简单、通用、廉价且可靠的预后参数,可用于识别 IE 患者的住院死亡风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43f4/9159181/a767ccbf45bc/IJCLP2022-8667054.001.jpg

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