Babes Elena Emilia, Radu Andrei-Flavius, Babeş Victor Vlad, Tunduc Paula Ioana, Radu Ada, Bungau Gabriela, Bustea Cristiana
Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania.
Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania.
Medicina (Kaunas). 2025 Jun 17;61(6):1095. doi: 10.3390/medicina61061095.
: Assessing risk is essential for optimal care in acute pulmonary embolism (PE). The present research seeks to evaluate the value of admission blood cellular indices as predictors of in-hospital outcome in acute PE and their utility in conjunction with validated risk tools such as the Pulmonary Embolism Severity Index (PESI) score and the European Society of Cardiology (ESC) risk stratification. : A total of 1058 individuals hospitalized at Bihor County Emergency Hospital, Oradea, Romania, with a diagnosis of acute PE confirmed by contrast-enhanced computed tomographic pulmonary angiography were retrospectively evaluated. : A total of 165 patients (18.2%) experienced adverse outcomes, including in-hospital mortality, cardiac arrest, cardiogenic shock, or persistent hypotension, and required rescue thrombolytic therapy. The neutrophil-to-lymphocyte ratio (NLR) was an independent predictor for in-hospital adverse outcome OR = 1.071 (95% CI 1.01-1.137), < 0.001. NLR as a predictor of adverse outcome had an AUC of 0.712 (95% CI 0.661-0.742), < 0.001, sensitivity of 72.56%, and specificity of 64.19% for a cutoff value of >5.493. In a combined model with PESI or with ESC risk classification, NLR is leading to a significant improvement in their AUC ( < 0.001). : Among hematological markers, NLR holds the greatest relevance for stratifying risk in acute pulmonary embolism and serves as an independent indicator of unfavorable in-hospital prognosis. NLR had an acceptable discriminative power to predict short-term complications and can increase the predictive value of the PESI score and of ESC risk classification.
评估风险对于急性肺栓塞（PE）的最佳治疗至关重要。本研究旨在评估入院血细胞指数作为急性PE住院结局预测指标的价值，以及它们与经过验证的风险工具（如肺栓塞严重程度指数（PESI）评分和欧洲心脏病学会（ESC）风险分层）联合使用的效用。
对罗马尼亚奥拉迪亚比霍尔县急诊医院收治的1058例经对比增强计算机断层扫描肺动脉造影确诊为急性PE的患者进行了回顾性评估。
共有165例患者（18.2%）出现不良结局，包括住院死亡率、心脏骤停、心源性休克或持续性低血压，并需要进行抢救性溶栓治疗。中性粒细胞与淋巴细胞比值（NLR）是住院不良结局的独立预测指标，OR = 1.071（95%CI 1.01 - 1.137），P < 0.001。NLR作为不良结局的预测指标，AUC为0.712（95%CI 0.661 - 0.742），P < 0.001，截断值>5.493时，敏感性为72.56%，特异性为64.19%。在与PESI或ESC风险分类的联合模型中，NLR可显著提高其AUC（P < 0.001）。
在血液学标志物中，NLR与急性肺栓塞的风险分层最为相关，是住院预后不良的独立指标。NLR对预测短期并发症具有可接受的判别能力，可提高PESI评分和ESC风险分类的预测价值。
