Song Chao, Hu Zhenkui, Zhang Jinhui
Department of Emergency Medicine, The Affiliated Hospital, Jiangsu University, Zhenjiang, Jiangsu, China.
Department of Critical Care Medicine, The Affiliated Hospital, Jiangsu University, Zhenjiang, Jiangsu, China.
Front Mol Biosci. 2024 Sep 13;11:1429372. doi: 10.3389/fmolb.2024.1429372. eCollection 2024.
The lymphocyte-to-C-reactive protein ratio (LCR) was a novel biomarker of inflammation that had been implicated in various diseases. Nevertheless, the role of LCR in the context of sepsis patients admitted to the Intensive Care Unit (ICU) had not been thoroughly elucidated. This study aimed to determine the significance of the LCR in predicting the prognosis of sepsis patients within ICU.
A sample of sepsis patients requiring ICU care was selected from the Affiliated Hospital of Jiangsu University. These patients were then segmented into four quartiles based on their LCR levels. The primary endpoint of the study was 30-day mortality and the secondary endpoint was the occurrence of Acute Kidney Injury (AKI). Survival analysis, via the Kaplan-Meier method and log-rank test, was conducted to assess survival rates. Cox proportional hazards regression and logistic regression models were employed to investigate the association between LCR and clinical outcomes. Additional subgroup analyses were conducted to evaluate the influence of other confounding factors on the relationship between LCR and patient outcomes.
A total of 1,123 patients were enrolled in this study, with a median age of 75 (65-84) years, and 707 (63.0%) of them were male. The 30-day mortality rate was 28.1%, while the incidence of AKI was 45.6%. A progressive decrease in LCR levels was found to be associated with an increased cumulative incidence of 30-day mortality (log-rank < 0.001). Multivariable Cox proportional hazards analyses demonstrated that LCR was an independent predictor of 30-day mortality [per 1-unit increase in LCR: HR (95%CI): 0.370 (0.142-0.963); = 0.042]. Additionally, multivariable logistic regression analysis revealed a significant association between LCR and AKI occurrence [per 1-unit increase in LCR: OR (95%CI): 0.541 (0.307-0.953); = 0.034]. Furthermore, subgroup analysis indicated a stronger correlation for patients aged over 65 years compared to those aged 65 or younger ( for interaction <0.05) in predicting 30-day mortality or AKI occurrence based on LCR.
A reduction in LCR was notably linked to 30-day mortality and the occurrence of AKI in sepsis patients. These findings suggested that LCR could potentially serve as a valuable tool in identifying sepsis patients at a heightened risk of adverse outcomes.
淋巴细胞与C反应蛋白比值（LCR）是一种新型炎症生物标志物，与多种疾病有关。然而，LCR在入住重症监护病房（ICU）的脓毒症患者中的作用尚未得到充分阐明。本研究旨在确定LCR在预测ICU内脓毒症患者预后方面的意义。
从江苏大学附属医院选取需要ICU护理的脓毒症患者样本。然后根据他们的LCR水平将这些患者分为四个四分位数。该研究的主要终点是30天死亡率，次要终点是急性肾损伤（AKI）的发生。通过Kaplan-Meier方法和对数秩检验进行生存分析，以评估生存率。采用Cox比例风险回归和逻辑回归模型来研究LCR与临床结局之间的关联。进行了额外的亚组分析，以评估其他混杂因素对LCR与患者结局之间关系的影响。
本研究共纳入1123例患者，中位年龄为75（65 - 84）岁，其中707例（63.0%）为男性。30天死亡率为28.1%，AKI发生率为45.6%。发现LCR水平的逐渐降低与30天死亡率的累积发生率增加相关（对数秩<0.001）。多变量Cox比例风险分析表明，LCR是30天死亡率的独立预测因子[LCR每增加1个单位：HR（95%CI）：0.370（0.142 - 0.963）；P = 0.042]。此外，多变量逻辑回归分析显示LCR与AKI发生之间存在显著关联[LCR每增加1个单位：OR（95%CI）：0.541（0.307 - 0.953）；P = 0.034]。此外，亚组分析表明，在基于LCR预测30天死亡率或AKI发生方面，65岁以上患者比65岁及以下患者的相关性更强（交互作用P<0.05）。
LCR降低与脓毒症患者的30天死亡率和AKI发生显著相关。这些发现表明，LCR可能是识别不良结局风险较高的脓毒症患者的有价值工具。
