Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Angiology. 2024 Sep;75(8):786-795. doi: 10.1177/00033197231196174. Epub 2023 Aug 16.
The present study aimed to explore the association between the neutrophil-to-lymphocyte ratio (NLR) and prognosis of critically ill chronic heart failure patients. The records of 5298 patients who met the inclusion criteria were extracted from the Medical Information Mart for Intensive Care IV database. The primary outcome was 30-days all-cause mortality and the secondary outcome was 90-days all-cause mortality. Multivariable logistic regression analysis was performed to examine the relationship between NLR and 30-days mortality. Subgroup analysis was carried out to identify whether the association between NLR and 30-days mortality differed across various subgroups. For 30-days mortality, after adjusting for multiple confounders, the odds ratio (OR) (95% confidence interval [CI]) for the second (NLR 4.0-8.4) and the third (NLR ≥8.4) tertiles were 1.52 (1.13-2.03) and 2.53 (1.92-3.34), respectively, compared with the first tertile (NLR <4.0). As for 90-days mortality, the OR for the second (NLR 4.0-8.4) was 1.34 (1.07-1.67) and 2.23 (1.81-2.76) for the third (NLR ≥8.4) tertiles compared with the reference (NLR<4.0). The interactions between the sepsis subgroup and 30-days mortality were significant. Our study concluded that the NLR was an independent predictor of 30- and 90-days mortality for critically ill patients with chronic heart failure.
本研究旨在探讨中性粒细胞与淋巴细胞比值(NLR)与危重症慢性心力衰竭患者预后的关系。从 Medical Information Mart for Intensive Care IV 数据库中提取符合纳入标准的 5298 例患者的记录。主要结局为 30 天全因死亡率,次要结局为 90 天全因死亡率。采用多变量逻辑回归分析来检验 NLR 与 30 天死亡率之间的关系。进行亚组分析以确定 NLR 与 30 天死亡率之间的关联是否在不同亚组之间存在差异。对于 30 天死亡率,在校正了多个混杂因素后,第二(NLR 4.0-8.4)和第三(NLR≥8.4)三分位组的比值比(OR)(95%置信区间[CI])分别为 1.52(1.13-2.03)和 2.53(1.92-3.34),与第一三分位组(NLR <4.0)相比。对于 90 天死亡率,第二(NLR 4.0-8.4)的 OR 为 1.34(1.07-1.67),第三(NLR≥8.4)的 OR 为 2.23(1.81-2.76),与参考组(NLR<4.0)相比。在 30 天死亡率的脓毒症亚组之间存在显著的交互作用。我们的研究表明,NLR 是危重症慢性心力衰竭患者 30 天和 90 天死亡率的独立预测因子。