Association Between the Neutrophil Percentage-to-Albumin Ratio and Outcomes in Cardiac Intensive Care Unit Patients

Abstract

Background The neutrophil percentage-to-albumin ratio (NPAR) is a systemic inflammation-based predictor associated with many diseases’ outcomes. Nevertheless, there are few studies on the relationship between NPAR and inflammatory markers, and more importantly, the prognostic value of NPAR in critically ill patients with cardiovascular disease (CVD) remains unknown. Methods The data of this retrospective cohort study were from the Medical Information Mart data for Intensive Care III database (MIMIC-III) and the Second Affiliated Hospital of Wenzhou Medical University. Linear regression, logistic regression model, and Cox regression model were used to assess the associations between NPAR levels and length of stay, renal replacement therapy (RRT) use, and 30-day, 90-day and one-year mortality, respectively. The Pearson correlation coefficient was used to present the correlation between NPAR and C-reactive protein (CRP). Results Our study included 1599 patients in MIMIC-III and 143 patients in the Second Affiliated Hospital of Wenzhou Medical University. The elevated NPAR was independently associated with increased 30-day, 90-day, and one-year all-cause mortality (adjusted HR, 95% CI:1.51 (1.02–2.24); 1.61 (1.14–2.28); 1.53 (1.15–2.03); P trend = 0.0297; 0.0053; 0.0023; respectively), and it was also associated with increase the length of stay in hospital and ICU (β, 95% CI: 2.76 (1.26–4.27); 1.54 (0.62–2.47), respectively, both P trend <0.001). We found that patients with higher NPAR were more likely to receive RRT (OR, 95% CI: 2.50 (1.28–4.89), P trend =0.0023). Moreover, we confirmed that NPAR was statistically positively correlated with CRP (correlation coefficient r = 0.406, P < 0.0001). Conclusion Elevated NPAR on admission was independently associated with increased all-cause mortality and length of stay among CICU patients. The results showed that CICU patients with higher NPAR were more likely to receive RRT. Besides, we also provided the evidence that there is a positive correlation between NPAR and inflammatory indicators (ie, CRP).

The association between Monocyte‐to‐Lymphocyte ratio and postoperative delirium in ICU patients in cardiac surgery

“…We conducted a single‐center retrospective cohort study; we collected all relevant data from Medical Information Mart for Intensive Care‐III (MIMIC‐III Version 1.4) 27–29 database. MIMIC‐III database is an open and freely available database developed by the Maslach‐setts Institute of Technology (MIT) computational Physiology Laboratory.…”

Prognostic nutrition index is associated with the all‐cause mortality in sepsis patients: A retrospective cohort study

“…The data in the present study were obtained from the MIMIC-III database (version 1.4) 26,27 and included the definitive health records of more than 50,000 critically ill patients, who were admitted between 2001 and 2012, to the Beth Israel Deaconess Medical Center (Boston, MA, USA). The design of the database was approved by the Institutional Review Board of the Massachusetts Institute of Technology (Cambridge, MA, USA) and Beth Israel Deaconess Medical Center (Boston, MA, USA).…”

Prediction Models for One-Year Survival of Adult Patients with Acute Kidney Injury: A Longitudinal Study Based on the Data from the Medical Information Mart for Intensive Care III Database

“…NLR and PLR were also identified to be associated with the prognosis of pulmonary embolism patients [ 10 ]. In a study by Wang et al, the increased NPAR level on admission was found to be associated with elevated all-cause mortality of patients in cardiac intensive care unit [ 11 ]. Additionally, PNI [ 12 ], PLR [ 13 ], NPAR [ 14 ], and NLR [ 15 ] were identified to be important prognostic biomarkers for AKI.…”