老年血流感染患者中性粒细胞与白蛋白比值、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值与住院死亡率的关系
Association Between Neutrophil Percentage to-Albumin Ratio, Neutrophil to-Lymphocyte Ratio, Platelet-to Lymphocyte Ratio and in-Hospital Mortality in Elder Patients with Bloodstream Infections.
作者信息
Yu Zhenghao, Liu Chuanbin, Gong Meiliang, Zhang Pinzheng, Pei Changbai, Liu Xinran, Han Xinjie, Zhu Pingjun, Xu Guogang, Du Yingzhen
机构信息
Health Management Institute, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, People's Republic of China.
Medical School of Chinese PLA, Beijing, People's Republic of China.
出版信息
J Inflamm Res. 2025 Aug 22;18:11509-11520. doi: 10.2147/JIR.S524259. eCollection 2025.
BACKGROUND
Bloodstream infections (BSI) is one of the major complications in elder inpatients, which is closely related to inflammation. Neutrophil percentage-to-albumin ratio (NPAR), Neutrophil-to-lymphocyte ratio (NLR), and Platelet-to-lymphocyte (PLR) are convenient predictors of inflammation and poor prognosis for a wide range of diseases. However, the association of NPAR, NLR and PLR with in-hospital mortality in elder inpatients with BSI are unclear. This study aimed to investigate the association and the predictive value of NPAR, NLR and PLR with in-hospital mortality.
METHODS
This study included older patients with BSI who were hospitalized in a large healthcare center in Beijing from December 2011 to January 2024. Kaplan-Meier curves and Cox regression analysis were used to explore the association of NPAR, NLR and PLR with in-hospital mortality. Restricted cubic spline analysis and Receiver operating characteristics (ROC) were performed to access the dose-response relationship and predictive value of NPAR, NLR and PLR with in-hospital mortality, respectively.
RESULTS
A total of 511 older patients with BSI were included in this study, with a mean age of 89.9±8.5 years, of which 85 deaths occurred during hospitalization (16.6%). After adjustment, the continuous NPAR level was associated with increased risk of in-hospital mortality (hazard ratio [HR] = 1.08, 95% confidence interval [CI]: 1.05, 1.12). The third tertile group of NPAR significantly increased the risk of in-hospital mortality compared to the first tertile group of NPAR (HR = 3.36, 95% CI: 1.87, 6.02). However, no association between NLR, PLR and in-hospital mortality was found. The area under the ROC curve of NPAR, NLR, and PLR for predicting mortality were 0.681 (95% CI: 0.615-0.747), 0.666 (95% CI: 0.598-0.733), and 0.510 (95% CI: 0.420-0.559), respectively.
CONCLUSION
Elevated NPAR was associated with higher risk of in-hospital mortality in older patients with BSI. NPAR may serve as a convenient and simple prognostic indicator.
背景
血流感染（BSI）是老年住院患者的主要并发症之一，与炎症密切相关。中性粒细胞与白蛋白比值（NPAR）、中性粒细胞与淋巴细胞比值（NLR）以及血小板与淋巴细胞比值（PLR）是多种疾病炎症和不良预后的便捷预测指标。然而，NPAR、NLR和PLR与老年BSI住院患者院内死亡率的关系尚不清楚。本研究旨在探讨NPAR、NLR和PLR与院内死亡率的关系及预测价值。
方法
本研究纳入了2011年12月至2024年1月在北京一家大型医疗中心住院的老年BSI患者。采用Kaplan-Meier曲线和Cox回归分析探讨NPAR、NLR和PLR与院内死亡率的关系。分别进行受限立方样条分析和受试者工作特征（ROC）分析，以评估NPAR、NLR和PLR与院内死亡率的剂量反应关系和预测价值。
结果
本研究共纳入511例老年BSI患者，平均年龄89.9±8.5岁，其中85例在住院期间死亡（16.6%）。调整后，连续NPAR水平与院内死亡风险增加相关（风险比[HR]=1.08，95%置信区间[CI]：1.05，1.12）。与NPAR第一三分位数组相比，NPAR第三三分位数组显著增加了院内死亡风险（HR=3.36，95%CI：1.87，6.02）。然而，未发现NLR、PLR与院内死亡率之间存在关联。NPAR、NLR和PLR预测死亡率的ROC曲线下面积分别为0.681（95%CI：0.615-0.747）、0.666（95%CI：0.598-0.733）和0.510（95%CI：0.420-0.559）。
结论
NPAR升高与老年BSI患者较高的院内死亡风险相关。NPAR可作为一种便捷、简单的预后指标。
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