[中性粒细胞与淋巴细胞比值作为坏死性筋膜炎患者死亡率的预测指标]
[Neutrophil-lymphocyte ratio as predictor of mortality in patients with necrotizing fasciitis].
作者信息
Ávila-Mercado Octavio, Flores-Gamboa Víctor, Reyes-Ruiz José Manuel, Campos-Hernández Paola, Martínez-Mier Gustavo
机构信息
Instituto Mexicano del Seguro Social, Centro Médico Nacional "Lic. Adolfo Ruiz Cortines", Hospital de Especialidades No. 14, Servicio de Cirugía General. Veracruz, Veracruz, México.
Instituto Mexicano del Seguro Social, Centro Médico Nacional "Lic. Adolfo Ruiz Cortines", Hospital de Especialidades No. 14, División de Investigación en Salud. Veracruz, Veracruz, México.
出版信息
Rev Med Inst Mex Seguro Soc. 2024 Jan 8;62(1):1-6. doi: 10.5281/zenodo.10278123.
BACKGROUND
Necrotizing fasciitis (NF) can affect any soft tissue and skin of the body. Its progression is rapid and it is associated with a high mortality rate. Therefore, the search for easily accessible and low-cost biomarkers that could predict the prognosis of patients with NF is necessary.
OBJECTIVE
To evaluate the role of neutrophil-lymphocyte ratio (NLR) as a predictor of mortality in patients with NF.
MATERIAL AND METHODS
Observational, cross-sectional, retrospective and analytical study of patients admitted between April and October 2020 in a tertiary-care hospital. The statistical tests used for the comparison of variables between the study groups were chi-square, Fisher's exact, Student's t and Mann-Whitney U. A receiver operating characteristic (ROC) curve was performed to determine the accuracy of NLR in predicting mortality in patients with NF.
RESULTS
A total of 25 patients were included and stratified into non-survivors and survivors. The non-survivor group had an elevated NLR value compared to survivors (15.57 [13.75] vs. 7.91 [4.13]; p = 0.065). The NLR had an area under the curve (AUC) of 0.729 (95% confidence interval [95% CI] 0.516-0.886; p = 0.044), sensitivity of 77.78% (40-97.2), and specificity of 75% (47.6-92.7). The optimal cut-off point obtained for NLR was > 9.21.
CONCLUSIONS
An NLR value > 9.21 could be a predictor of mortality in patients with NF.
背景
坏死性筋膜炎（NF）可累及身体的任何软组织和皮肤。其进展迅速，且死亡率高。因此，寻找易于获取且低成本的生物标志物以预测NF患者的预后很有必要。
目的
评估中性粒细胞与淋巴细胞比值（NLR）作为NF患者死亡率预测指标的作用。
材料与方法
对2020年4月至10月在一家三级医院住院的患者进行观察性、横断面、回顾性和分析性研究。用于比较研究组间变量的统计检验有卡方检验、费舍尔精确检验、学生t检验和曼-惠特尼U检验。绘制受试者工作特征（ROC）曲线以确定NLR预测NF患者死亡率的准确性。
结果
共纳入25例患者，并分为非存活者和存活者。与存活者相比，非存活者组的NLR值升高（15.57[13.75]对7.91[4.13]；p = 0.065）。NLR的曲线下面积（AUC）为0.729（95%置信区间[95%CI]0.516 - 0.886；p = 0.044），敏感性为77.78%（40 - 97.2），特异性为75%（47.6 - 92.7）。NLR的最佳截断点为> 9.21。
结论
NLR值> 9.21可能是NF患者死亡率的预测指标。
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