Chonnam National University Hospital, Department of Emergency Medicine, Gwangju, Republic of Korea.
Chonnam National University Medical School, Department of Emergency Medicine, Gwangju, Republic of Korea.
West J Emerg Med. 2024 Jan;25(1):129-135. doi: 10.5811/westjem.61343.
The platelet-to-lymphocyte ratio (PLR) is associated with the inflammatory response in various diseases. However, studies on the use of the PLR for the prognosis of elderly patients with severe trauma are lacking. In this study, we examined the relationship between the PLR and in-hospital mortality in elderly patients with severe trauma.
This retrospective observational study included elderly (≥65 years) patients who were admitted for severe trauma (as defined by an Injury Severity Score [ISS] ≥ 16) between January-December 2022. We conducted multivariate analysis to assess the association between the PLR and in-hospital mortality using logistic regression of relevant covariates. We also performed receiver operating characteristic curve analysis to examine the prognostic performance of the PLR for in-hospital mortality.
Among the 222 patients included in the study, the in-hospital mortality rate was 19.4% (43). The PLR of non-survivors was lower than that of survivors (62.1 vs 124.5). The areas under the curve (AUC) of the Glasgow Coma Scale (GCS) score ≤12, ISS, hemoglobin level, and PLR for predicting in-hospital mortality were 0.730 (95% confidence interval [CI] 0.667-0.787), 0.771 (95% CI 0.710-0.824), 0.657 (95% CI 0.591-0.719), and 0.730 (95% CI 0.667-0.788), respectively. The AUC of the PLR was not significantly different from that of GCS score ≤12 and ISS for predicting in-hospital mortality. Multivariate analysis showed that the PLR was independently associated with in-hospital mortality (odds ratio: 0.993; 95% CI 0.987-0.999).
Low platelet-to-lymphocyte ratio is independently associated with in-hospital mortality in elderly patients with severe trauma.
血小板与淋巴细胞比值（PLR）与各种疾病的炎症反应有关。然而，关于 PLR 用于预测老年严重创伤患者预后的研究尚缺乏。本研究旨在探讨 PLR 与老年严重创伤患者住院死亡率的关系。
这是一项回顾性观察性研究，纳入了 2022 年 1 月至 12 月期间因严重创伤（损伤严重程度评分 [ISS]≥16）入院的老年（≥65 岁）患者。我们使用多元逻辑回归分析了相关协变量，评估了 PLR 与住院死亡率之间的关系。我们还进行了受试者工作特征曲线分析，以评估 PLR 对住院死亡率的预后性能。
在纳入的 222 例患者中，住院死亡率为 19.4%（43 例）。非幸存者的 PLR 低于幸存者（62.1 与 124.5）。格拉斯哥昏迷量表（GCS）评分≤12、ISS、血红蛋白水平和 PLR 预测住院死亡率的曲线下面积（AUC）分别为 0.730（95%置信区间 [CI] 0.667-0.787）、0.771（95% CI 0.710-0.824）、0.657（95% CI 0.591-0.719）和 0.730（95% CI 0.667-0.788）。PLR 的 AUC 与 GCS 评分≤12 和 ISS 预测住院死亡率的 AUC 无显著差异。多变量分析表明，PLR 与住院死亡率独立相关（比值比：0.993；95% CI 0.987-0.999）。
低血小板与淋巴细胞比值与老年严重创伤患者住院死亡率独立相关。
