Long Xinguang, Hu Zhenkui, Song Chao, Zhang Jinhui
Department of Cardiology, Yangzhong People's Hospital, YangZhong, Jiangsu, China.
Department of Emergency Medicine, The Affiliated Hospital, Jiangsu University, Zhenjiang, Jiangsu, China.
Front Cell Infect Microbiol. 2025 Jan 14;14:1507992. doi: 10.3389/fcimb.2024.1507992. eCollection 2024.
The D-dimer to lymphocyte ratio (DLR), a novel inflammatory biomarker, had been shown to be related to adverse outcomes in patients with various diseases. However, there was limited research on the relationship between the DLR and adverse outcomes in patients with infectious diseases, particularly those with sepsis. Therefore, this study aimed to explore the association between the DLR and in hospital all-cause mortality in elderly patients with sepsis.
A total of 1123 patients admitted in intensive care unit (ICU) were included in this study. The patients were categorized into quartiles (Q1-Q4) based on their DLR values. The primary outcomes included hospital mortality and ICU mortality. Kaplan-Meier analysis was conducted to compare all-cause mortality among the four DLR groups. The association between DLR and all-cause mortality in patients with sepsis was further elucidated using the receiver operating characteristic (ROC) curve and Cox proportional hazards regression analysis.
The study included participants with a median age of 75 (65-84) years, with 707 (63.0%) being male. The rates of hospital mortality and ICU mortality were 33.7% and 31.9%, respectively. Kaplan-Meier analysis highlighted a significantly increased risk of all-cause mortality among patients with elevated DLR values (log-rank p < 0.001). ROC curve analyses revealed that DLR had a stronger ability to predict hospital mortality and ICU mortality in patients with sepsis than D-dimer or Lym. Multivariable Cox proportional hazards analyses revealed DLR as an independent predictor of hospital death [per 1 SD increase in DLR: HR (95% CI): 1.098 (1.020-1.181); p = 0.013] and ICU death [per 1 SD increase in DLR: HR (95% CI): 1.095 (1.017-1.180); p = 0.017] during the hospital stay.
A higher DLR value was associated with hospital and ICU all-cause death in elderly patients with sepsis. This finding demonstrated that the DLR could be a convenient and useful prognostic marker for sepsis prognosis.
D - 二聚体与淋巴细胞比值（DLR）是一种新型炎症生物标志物，已被证明与多种疾病患者的不良预后相关。然而，关于DLR与传染病患者，尤其是脓毒症患者不良预后之间关系的研究有限。因此，本研究旨在探讨DLR与老年脓毒症患者院内全因死亡率之间的关联。
本研究共纳入1123例入住重症监护病房（ICU）的患者。根据DLR值将患者分为四分位数（Q1 - Q4）。主要结局包括医院死亡率和ICU死亡率。采用Kaplan - Meier分析比较四个DLR组的全因死亡率。使用受试者工作特征（ROC）曲线和Cox比例风险回归分析进一步阐明DLR与脓毒症患者全因死亡率之间的关联。
该研究纳入的参与者中位年龄为75（65 - 84）岁，其中707例（63.0%）为男性。医院死亡率和ICU死亡率分别为33.7%和31.9%。Kaplan - Meier分析强调，DLR值升高的患者全因死亡风险显著增加（对数秩检验p < 0.001）。ROC曲线分析显示，与D - 二聚体或淋巴细胞计数相比，DLR预测脓毒症患者医院死亡率和ICU死亡率的能力更强。多变量Cox比例风险分析显示，DLR是住院期间医院死亡[DLR每增加1个标准差：HR（95%CI）：1.098（1.020 - 1.181）；p = 0.013]和ICU死亡[DLR每增加1个标准差：HR（95%CI）：1.095（1.017 - 1.180）；p = 0.017]的独立预测因素。
较高的DLR值与老年脓毒症患者的医院和ICU全因死亡相关。这一发现表明，DLR可能是脓毒症预后的一种方便且有用的预后标志物。
