Association of Lymphocyte to Monocyte Ratio and Risk of in-Hospital Mortality in Patients with Cardiogenic Shock: A Propensity Score Matching Study

Abstract

Background Lymphocyte to monocyte ratio (LMR) has been long implicated in the prediction of many inflammatory-related diseases. However, the possible value as prognostic marker of LMR have not been evaluated in cardiogenic shock (CS) patients. The aim of the study was to assess the relationship between LMR on admission and in-hospital mortality in CS patients. Methods Data on patients diagnosed with CS were extracted from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. We performed a single-institution, retrospective study of 1487 CS patients and determined the optimal cut-off for LMR by X-tile software. Propensity score matching (PSM) and inverse probabilities of treatment weighting (IPTW) were conducted to control confounders. Cox proportional hazards model was performed to evaluate the relationship between LMR and in-hospital mortality. Kaplan–Meier curves and receiver operating characteristics (ROC) analysis were applied to assess the prognostic value of LMR. Results The optimal cut-off value for LMR was 0.9. Cox proportional hazards model demonstrated that lower LMR (< 0.9) was independently associated with in-hospital mortality with hazard ratio (HR) of 1.40 (1.12–1.74, P = 0.003). The results were consistent with survival analyses ( P < 0.001, Log rank test). Adding LMR< 0.9 to the sequential organ failure assessment (SOFA) score improved discrimination and risk stratification for in-hospital mortality. Conclusion Lower level of LMR is related to higher risk of in-hospital mortality of patients with CS. As an easily available biomarker, LMR can independently predict the in-hospital mortality in CS patients.

Intraoperative nociception and postoperative inflammation associated with the suppression of major complications due to thoracic epidural block after pleurectomy/decortication for malignant pleural mesothelioma under general anesthesia: A retrospective observational study

“…[5] On the other hand, the increase in the LMR indicates an increase in lymphocyte counts or a decrease in monocyte, correlating with anti-inflammation, which suppresses morbidity or mortality. [14][15][16] Previous studies have revealed that increases in sympathetic activity, accompanied by excessive nociception, contribute to hematopoiesis in the bone marrow, including neutrophils and monocytes, [17,18] This excessive acute inflammation has been shown to cause postoperative complications. [5] Therefore, the suppression of nociception caused by TEB, which was observed as lower values of mean NR in the present study, is likely associated with a reduction in acute inflammation.…”

The best of both worlds: no apparent trade-off between immunity and reproduction in two group-living African mole-rat species

“…Furthermore, memory T and B lymphocytes not only are essential to immunity against microbial pathogens, but are also involved in autoimmunity and maternal-fetal tolerance [32]. Ratios of these leukocytic components have proven invaluable as prognostic tools for diagnosing the degree of inflammation, disease severity, mortality and tumorigenesis [33][34][35][36][37][38]. Lower neutrophil-to-lymphocyte ratio (NLR) is usually associated with favourable prognostic factors in every field of application, mirroring a preserved immune balance [24][25][26][27][28][29], while, a higher monocycte-to-lymphocyte ratio (MLR) is favourably associated with disease-free survival after infection or cancer [24][25][26][27][28][29].…”