中性粒细胞与淋巴细胞比值与急诊手术后年龄和 180 天死亡率的关系。

Association of neutrophil-to-lymphocyte ratio with age and 180-day mortality after emergency surgery.

机构信息

Department of Anesthesia and Perioperative Medicine, Faculty of Medicine, Hospital Clínico de la Universidad de Chile, Universidad de Chile, Santiago, Chile.

Faculty of Medicine, Universidad de Chile, Santiago, Chile.

出版信息

BMC Anesthesiol. 2024 Sep 17;24(1):329. doi: 10.1186/s12871-024-02718-z.

DOI:10.1186/s12871-024-02718-z

PMID:39289610

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11406743/

Abstract

BACKGROUND

To examine the relationship between neutrophil-to-lymphocyte ratio (NLR), age, and mortality rates after emergency surgery.

METHODS

In this observational study, a total of 851 patients undergoing emergency surgery between January 2022 and January 2023 were retrospective examined. Using 30 and 180 days mortality data, NLR differences and receiver operating characteristic (ROC) curves were analyzed using a 65-year threshold. A multiple logistic regression model was constructed incorporating age and NLR. Finally, Kaplan-Meier curves were constructed for mortality.

RESULTS

Among 851 patients, the 30 and 180 days mortality rates were 5.2% and 10.8%, respectively. Median NLR in 30 days was 5.6 (3.1 to 9.6) in survivors and 8.7 (4.6 to 13.4) in deceased patients (p < 0.0001); in 180 days, it was 5.5 (3.1 to 9.8) and 8.8 (4.8 to 14.5), respectively (p < 0.0001). In the 30- and 180-days mortality analyses, median NLRs were 5.1 (2.9 to 8.9) and 4.9 (2.9 to 8.8) in survivors and 10.6 (6.9 to 16.6) and 9.3 (5.4 to 14.9) in deceased patients aged < 65 years, respectively. The ROC AUC in patients younger than 65 years was higher for 30 days (AUC 0.75; 95% CI 0.72 to 0.87) and 180 days (AUC 0.73; 95% CI 0.64 to 0.81). Multivariate logistic regression revealed that the NLR (odds ratio, 1.03 [95% CI 1.005 to 1.053; p = 0.0133) and age (odds ratio, 1.05 [95% CI 1.034 to 1.064; p < 0.0001) significantly contributed to the model. Survival analysis revealed differences in the 180 days mortality (p = 0.0006).

CONCLUSION

We observed differences in preoperative NLR between patients who survived and those who died after emergency surgery. Age impacts the use of NLR as a mortality risk factor.

TRIAL REGISTRATION

NCT06549101, retrospectively registered.

摘要

背景

探讨中性粒细胞与淋巴细胞比值（NLR）、年龄与急诊手术后死亡率的关系。

方法

本观察性研究回顾性分析了 2022 年 1 月至 2023 年 1 月期间接受急诊手术的 851 例患者。使用 30 天和 180 天死亡率数据，使用 65 岁阈值分析 NLR 差异和受试者工作特征（ROC）曲线。构建了包含年龄和 NLR 的多因素逻辑回归模型。最后，构建了死亡率的 Kaplan-Meier 曲线。

结果

在 851 例患者中，30 天和 180 天的死亡率分别为 5.2%和 10.8%。存活者 30 天 NLR 中位数为 5.6（3.1 至 9.6），死亡者为 8.7（4.6 至 13.4）（p<0.0001）；180 天 NLR 中位数分别为 5.5（3.1 至 9.8）和 8.8（4.8 至 14.5）（p<0.0001）。在 30 天和 180 天的死亡率分析中，存活者 NLR 中位数为 5.1（2.9 至 8.9），死亡者 NLR 中位数为 10.6（6.9 至 16.6）；存活者年龄<65 岁，其 NLR 中位数为 4.9（2.9 至 8.8），死亡者 NLR 中位数为 9.3（5.4 至 14.9）。年龄<65 岁患者的 30 天（AUC 0.75；95%CI 0.72 至 0.87）和 180 天（AUC 0.73；95%CI 0.64 至 0.81）ROC 曲线 AUC 更高。多变量逻辑回归显示 NLR（比值比，1.03[95%CI 1.005 至 1.053；p=0.0133]）和年龄（比值比，1.05[95%CI 1.034 至 1.064；p<0.0001）对模型有显著贡献。生存分析显示，180 天死亡率存在差异（p=0.0006）。