Department of Admission Service Centre, Affiliated Hospital of Jining Medical University, Jining, Shangdong, China.
Department of Critical Care Medicine Affiliated Hospital of Jining Medical University, Jining, Shandong, China.
J Int Med Res. 2023 Jun;51(6):3000605231178512. doi: 10.1177/03000605231178512.
To assess the association between neutrophil percentage-to-albumin ratio (NPAR) and 28-day mortality in severely ill Chinese patients with sepsis.
In this retrospective, single-centre study, sepsis patients admitted to the ICU of the Affiliated Hospital of Jining Medical University between May 2015 and December 2021 were retrospectively analysed. The relationship between NPAR and 28-day mortality was examined using Cox proportional-hazards model.
In total, 741 patients with sepsis were included. Multivariate analysis, adjusted for age, sex, body mass index (BMI), smoking and alcohol drinking history, showed an association between elevated NPAR and a high risk of 28-day mortality. After removal of additional confounders, moderate and high NPAR values remained significantly associated with 28-day mortality in comparison with low NPAR values (tertile 2 vs 1: HR, 95% CI: 1.42, 1.06-1.90; tertile 3 vs 1: HR, 95% CI: 1.35, 1.00-1.82). Survival curves stratified by NPAR groups showed that high NPAR levels had lower survival probabilities than lower NPAR levels. Subgroup analysis did not show any significant interactions between NPAR and 28-day mortality.
Elevated NPAR values were linked to increased 28-day mortality in severely ill Chinese patients with sepsis. The findings require verification by large, prospective, multi-centre studies.
评估中性粒细胞与白蛋白比值(NPAR)与中国严重脓毒症患者 28 天死亡率之间的关系。
本回顾性单中心研究纳入了 2015 年 5 月至 2021 年 12 月期间入住济宁医学院附属医院 ICU 的脓毒症患者。使用 Cox 比例风险模型检验 NPAR 与 28 天死亡率之间的关系。
共纳入 741 例脓毒症患者。多变量分析调整年龄、性别、体重指数(BMI)、吸烟和饮酒史后,发现 NPAR 升高与 28 天死亡率高相关。在去除其他混杂因素后,与低 NPAR 值相比,中值和高 NPAR 值与 28 天死亡率仍显著相关(三分位 2 与 1:HR,95%CI:1.42,1.06-1.90;三分位 3 与 1:HR,95%CI:1.35,1.00-1.82)。按 NPAR 分组的生存曲线显示,高 NPAR 水平的生存率低于低 NPAR 水平。亚组分析未显示 NPAR 与 28 天死亡率之间存在任何显著交互作用。
在中国严重脓毒症患者中,NPAR 值升高与 28 天死亡率增加相关。这些发现需要通过大型、前瞻性、多中心研究来验证。