Background. The prognosis of Infective endocarditis (IE) is poor, and we conducted this investigation to evaluate the worth of admission lymphocyte-to-white blood cell ratio (LWR) for prediction of short-term outcome in IE patients. Methods. We retrospectively assessed the medical records of 147 IE patients from January 2017 to December 2019. Patients were divided into the survivor group and nonsurvivor group. Univariate and multivariate analyses were applied to estimate the independent factors contribution to in-hospital death, and receiver-operator characteristic (ROC) curve was utilized to check the performance. Results. The levels of LWR (0.17 ± 0.08 vs. 0.10 ± 0.06) were significantly increased among the survivor group compared with the nonsurvivor group ( P  = 0.001). Multivariate analysis displayed that LWR (hazard ratio (HR): 1.755, 1.304–2.362, P  < 0.001) was not interfered by other confounding factors for early death. Moreover, ROC analysis suggested that LWR (cutoff value = 0.10) performed the best among assessed indexes for the forecast of primary outcome (area under curve (AUC) = 0.750, 95% confidence interval (CI) = 0.634–0.867, P  < 0.001, sensitivity = 70.0%, specificity = 76.4%), and the proportion of in-hospital mortality was remarkably inferior in patients with LWR > 0.10 than in those with LWR ≤ 0.10. (5.83% vs. 31.8%, P  < 0.001). Conclusions. LMR is an independent, simple, universal, inexpensive, and reliable prognostic parameter to identify high-risk IE patients for in-hospital mortality.

Background. Early and rapid diagnosis is crucial in HIV preventing and treatment. However, the false-positive rate (FPR) by 4-th generation detection assays was high in low-HIV-prevalence regions. Objectives. To analyze the relation between sample-to-cutoff index (COI) and HIV confirmatory results, and to explore a new COI threshold in our own laboratory to predict HIV infection. Methods. We retrospectively analyzed primarily reactive results by Elecsys® HIV combi PT assays and their confirmatory results by western blot (WB) at Nanjing Center for Disease Control and Prevention (CDC). The mean COI values of true positive (TP), false positive (FP), and indeterminate groups were compared, and receiver operating characteristic curve (ROC) analysis was performed to determine the optimal COI value for predicting HIV infection. Results. Totally 150,980 HIV serological results were reviewed, and 305 (0.2%) were primarily reactive. There are 82 (26.89%) true positives, 210 (71.92%) false positives, and 11 indeterminate samples confirmed by WB tests, and another 2 patients rejected WB tests. Mean COI values of TP (643.5) were greatly higher than that of FP (3.174) ( P < 0.0001 ), but there is no significant difference between FP and indeterminate groups. Combining the requirement of HIV diagnosis and ROC analysis, 9.87 was established as the optimal threshold to predict the infection, with 100% sensitivity and 99.99% specificity. Conclusions. By adjusting the COI threshold, the FP samples can be reduced and the efficiency of screening assays can be increased, which can save much additional reagent and staff costs and much time for delivery of HIV test results.