Effect of lymphocyte-to-monocyte ratio on survival in septic patients: an observational cohort study.

INTRODUCTION

The purpose of the present study was to evaluate the potential relationship of lymphocyte-to-monocyte ratio (LMR) with outcomes of septic patients at intensive care unit (ICU) admission.

MATERIAL AND METHODS

3087 septic patients were included in the final cohort by using the Medical Information Mart for Intensive Care (MIMIC) database. We evaluated the association of different groups of LMR with 28-day survival and 1-year survival via Kaplan-Meier (K-M) analysis and Cox regression analysis. Subgroups analysis of LMR was performed to further explore the effect of LMR on survival.

RESULTS

According to the optimal cut-off value, the cohort was divided into low-LMR and high-LMR groups. The 28-day and 1-year survival rates were 47.9% and 19.9%, respectively, in the low-LMR group, and 60.4% and 25.9%, respectively, in the high-LMR group. Univariate logistic regression and K-M analyses revealed that the 28-day and 1-year survival rates of the high-LMR group were higher than those of the low-LMR group (both < 0.001). A subgroup analysis of LMR identified a significant stepwise decrease in the risk of death at 28 days and 1 year from group 1 to group 4 (LMR increased gradually) after adjustment for multiple variables.

CONCLUSIONS

We report for the first time that a lower LMR value is independently predictive of a poor prognosis in septic patients. Therefore, as an inexpensive and readily available indicator, LMR may facilitate stratification of prognosis in septic patients.