Zhu Jin, Zhang Chaorong, Deng Zhexuan, Ouyang Lifen
Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, 330003, China.
Baiyun Hospital of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510000, China.
BMC Infect Dis. 2025 May 9;25(1):685. doi: 10.1186/s12879-025-11064-5.
The immune system and inflammation are intimately linked to the pathophysiology of sepsis. The neutrophil‒platelet ratio (NPR), associated with inflammation and immunology, may be useful in predicting sepsis outcomes. According to earlier research, the NPR is linked to the prognosis of several diseases. This study aimed to investigate the connection between the NPR and unfavorable outcomes in patients with sepsis.
We retrieved patient clinical data from the Medical Information Mart for Intensive Care IV database (MIMIC-IV 2.2) based on the inclusion and exclusion criteria. The NPR quartile was used to divide the population into four groups. 28-day mortality was the main result, whereas 90-day mortality was the secondary result. The Cox regression model, Kaplan‒Meier survival curve, and limited cubic spline were used to examine the associations between the NPR and the negative outcomes of sepsis. Subgroup analysis was also conducted. At the same time, we used Latent Class Trajectory Model (LCTM) to assess the trajectory of NPR within six days of ICU admission, and to assess the relationship between NPR trajectory and mortality at 28 and 90 days.
This study included 3339 patients. Quartile 4 had the greatest 28-day and 90-day mortality rates, according to the Cox regression model and Kaplan‒Meier survival curve. A J-shaped relationship between the NPR and mortality was found in restricted cubic spline investigations. This means higher and lower NPRs were linked to higher mortality, with NPR = 3.81 as the tipping point. A total of 434 patients were included in the trajectory analysis, and three trajectory patterns were identified. Patients with sepsis had an increased mortality rate in the slow-decline group compared with the stable development group.
The NPR has prognostic value for patients with sepsis, and there is a J-shaped relationship between the two variables. Patients with sepsis who have a slowly declining NPR have an increased mortality rate.
Not applicable.
免疫系统和炎症与脓毒症的病理生理学密切相关。与炎症和免疫学相关的中性粒细胞与血小板比值（NPR）可能有助于预测脓毒症的预后。根据早期研究，NPR与几种疾病的预后有关。本研究旨在探讨NPR与脓毒症患者不良预后之间的关系。
我们根据纳入和排除标准，从重症监护医学信息集市IV数据库（MIMIC-IV 2.2）中检索患者临床数据。NPR四分位数用于将人群分为四组。28天死亡率是主要结果，而90天死亡率是次要结果。采用Cox回归模型、Kaplan-Meier生存曲线和受限立方样条来检验NPR与脓毒症阴性结果之间的关联。还进行了亚组分析。同时，我们使用潜在类别轨迹模型（LCTM）来评估ICU入院后六天内NPR的轨迹，并评估NPR轨迹与28天和90天死亡率之间的关系。
本研究纳入了3339例患者。根据Cox回归模型和Kaplan-Meier生存曲线，四分位数4的28天和90天死亡率最高。在受限立方样条研究中发现NPR与死亡率之间呈J形关系。这意味着较高和较低的NPR与较高的死亡率相关，以NPR = 3.81为转折点。共有434例患者纳入轨迹分析，确定了三种轨迹模式。与稳定发展组相比，脓毒症患者在缓慢下降组中的死亡率增加。
NPR对脓毒症患者具有预后价值，且这两个变量之间存在J形关系。NPR缓慢下降的脓毒症患者死亡率增加。
不适用。
