Predictive value of neutrophil-to-lymphocyte and platelet ratio in in-hospital mortality in septic patients.

BACKGROUND

Among critically ill patients in the intensive care unit (ICU), sepsis is an urgent global public health problem due to its high incidence, high mortality rate and complex pathogenesis.

OBJECTIVE

This study was to evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR), and neutrophil-to-lymphocyte and platelet ratio (NLPR) in-hospital mortality in septic patients on days 1, 3 and 5 in ICU.

METHODS

The data of septic patients admitted to the ICU of the Sixth Affiliated Hospital of Sun Yat-sen University from March, 2018 to July, 2019 were collected. NLR and NLPR were calculated and multivariate logistic regression analysis was performed to identify the relationship between them and in-hospital mortality, respectively. Receiver operating characteristic curve (ROC) was used to determine the efficacy and optimal cutoff value of diagnostic tests.

RESULTS

A total of 173 septic patients were included in this analysis, including 108 cases in the survival group and 65 in the death group, with a total mortality rate of 37.6%. A multivariate logistic regression analysis showed that NLR on day 5 was independently correlated with in-hospital mortality rate (OR 1.041, 95% CI: 1.008-1.074), and Day 5 NLPR was also independently associated with in-hospital mortality rate (OR 1.020, 95% CI: 1.001-1.040). The areas under the receiver operating characteristic curve (AUC) of the NLR on days 1 and 3 was 0.513 and 0.542 respectively, and the optimal cutoff value were 23.16 and 15.48, and the AUC of the NLR on day 5 was 0.589, and the best cutoff value was 15.85. The AUC of NLPR on day 1 and 3 was 0.517 and 0.547, respectively, and the optimal cutoff value was 10.25 and 18.47. The AUC of NLPR on day 5 was the largest, 0.654, and the optimal cutoff value was 8.22. After combined NLPR on day 5 with age and sequential organ failure assessment (SOFA) scores, the AUC increase to 0.718. Among the joint predictors, the optimal cutoff value for NLPR on day 5 was 9.31.

CONCLUSION

We found that Day 5 NLPR and NLR were independently correlated with in-hospital mortality. Day 5 NLPR Combined with age and SOFA scores may be help predict mortality in ICU septic hospitalized patients.