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脑出血患者血小板-淋巴细胞比值与90天死亡率的关联:来自多中心重症医学信息库-III数据库的数据

Association between platelet-lymphocyte ratio and 90-day mortality in patients with intracerebral hemorrhage: data from the MIMIC-III database.

作者信息

Yuan Min, Xiao Zhilong, Zhou Huangyan, Fu Anxia, Pei Zhimin

机构信息

Graduate School, Nanchang University, Nanchang, China.

Department of Neurology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China.

出版信息

Front Neurol. 2023 Oct 9;14:1234252. doi: 10.3389/fneur.2023.1234252. eCollection 2023.

Abstract

BACKGROUND

Recent evidence suggested that platelet-lymphocyte ratio (PLR) may play a role in the pathophysiology of intracerebral hemorrhage (ICH), but the results are controversial. This study aimed to explore the relationship between PLR and mortality in patients with ICH.

METHODS

All data were extracted from the Medical Information Mart for Intensive Care (MIMIC) III database. The study outcome was 90-day mortality. Multivariable Cox regression analyses were used to calculate the adjusted hazard ratio (HR) with a 95% confidence interval (CI), and curve-fitting (restricted cubic spline) was used to assess the non-linear relationship.

RESULTS

Of 1,442 patients, 1,043 patients with ICH were included. The overall 90-day mortality was 29.8% (311/1,043). When PLR was assessed in quartiles, the risk of 90-day mortality for ICH was lowest for quartile 2 (120.9 to <189.8: adjusted HR, 0.67; 95% CI: 0.48-0.93; = 0.016), compared with those in quartile 1 (<120.9. Consistently in the threshold analysis, for every 1 unit increase in PLR, there was a 0.6% decrease in the risk of 90-day mortality for ICH (adjusted HR, 0.994; 95% CI: 0.988-0.999) in those with PLR <145.54, and a 0.2% increase in 90-day mortality (adjusted HR, 1.002; 95% CI: 1.000-1.003) in participants with PLR ≥145.54.

CONCLUSION

There was a non-linear relationship between PLR and 90-day mortality for patients with ICH, with an inflection point at 145.54 and a minimal risk at 120.9 to <189.8 of PLR.

摘要

背景

近期证据表明,血小板淋巴细胞比率(PLR)可能在脑出血(ICH)的病理生理学中发挥作用,但结果存在争议。本研究旨在探讨ICH患者中PLR与死亡率之间的关系。

方法

所有数据均从重症监护医学信息数据库(MIMIC)III中提取。研究结局为90天死亡率。采用多变量Cox回归分析计算调整后的风险比(HR)及95%置信区间(CI),并采用曲线拟合(限制立方样条)评估非线性关系。

结果

在1442例患者中,纳入了1043例ICH患者。总体90天死亡率为29.8%(311/1043)。当按四分位数评估PLR时,与四分位数1(<120.9)中的患者相比,四分位数2(120.9至<189.8:调整后HR,0.67;95%CI:0.48 - 0.93;P = 0.016)中ICH患者的90天死亡风险最低。在阈值分析中,一致的是,对于PLR <145.54的患者,PLR每增加1个单位,ICH患者的90天死亡风险降低0.6%(调整后HR,0.994;95%CI:0.988 - 0.999),而对于PLR≥145.54的参与者,90天死亡率增加0.2%(调整后HR,1.002;95%CI:1.000 - 1.003)。

结论

ICH患者的PLR与90天死亡率之间存在非线性关系,拐点为145.54,PLR在120.9至<189.8时风险最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81dc/10591107/a0b92c48eb0d/fneur-14-1234252-g0001.jpg

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