Correlation analysis between the static and the changed neutrophil-to-lymphocyte ratio and in-hospital mortality in critical patients with acute heart failure

Liu, Tao; Wang, Bing; Xiao, Shengjue; Sun, Lifang; Zhu, Zhijian; Wang, Shasha; Li, Baoyin; Yao, Jianhui; Huang, Conggang; Ge, Wei; Qian, Lei; Lu, Zhigang; Pan, Yesheng

doi:10.1080/00325481.2022.2129177

Cited by 5 publications

(8 citation statements)

References 34 publications

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“…Finally, a total of 15 studies met the eligibility criteria and were included in the meta-analysis [ 11 , 12 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram is depicted in Supplementary Figure S1 .…”

Section: Resultsmentioning

confidence: 99%

“…All 15 studies were observational cohort studies, with 9 studies [ 11 , 12 , 17 , 18 , 19 , 20 , 22 , 23 , 24 ] being retrospective studies while the remaining 6 studies [ 16 , 21 , 25 , 26 , 27 , 28 ] were prospective in nature. A total of 15,995 patients with acute heart failure were studied.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Four studies compared the outcomes for patients with acute heart failure based on their NLR quartiles, with the highest quartile being compared to the lowest NLR quartile [ 11 , 12 , 25 , 26 ]. Of these, three studies [ 12 , 25 , 26 ] provided data on in-hospital mortality and three studies [ 11 , 25 , 26 ] reported on long-term all-cause mortality. The results of the meta-analysis revealed that there was no significant difference in terms of in-hospital mortality between the two groups of the patients [HR 1.78, 95% CI (0.91–3.47), p = 0.09, I 2 = 89.3%] ( Figure 2 A).…”

Section: Resultsmentioning

confidence: 99%

“…In particular, there has been an increased focus on the correlation of proinflammatory cytokines and other circulating biomarkers with the severity of congestive heart failure (CHF) and clinical outcomes. Evidence suggests that other biomarkers such as C-reactive protein (CRP) and the neutrophil lymphocyte ratio (NLR) correlate with elevations in circulating pro-inflammatory cytokines and can be implemented as surrogate measures for acute and chronic inflammation [ 1 , 3 , 6 , 10 , 11 , 12 ]. In addition, the NLR is indicative of the balance between the innate and adaptive immune system.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Patients with Acute Decompensated Heart Failure: A Meta-Analysis

Ang,

Chia,

Jaiswal

et al. 2024

JCM

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Background: Inflammation plays a pivotal role in the pathogenesis of both acute and chronic heart failure. Recent studies showed that the neutrophil-to-lymphocyte ratio (NLR) could be related to adverse outcomes in patients with cardiovascular diseases. We sought to evaluate whether NLR could predict mortality in patients with acute heart failure by means of a meta-analysis. Methods: A comprehensive literature search was performed in PubMed, Embase, and Cochrane databases through January 2023 for studies evaluating the association of NLR with mortality in patients with acute heart failure. Primary outcomes were in-hospital mortality and long-term all-cause mortality. Endpoints were pooled using a random-effects DerSimonian-and-Laird model and were expressed as a hazard ratio (HR) or mean difference (MD) with their corresponding 95% confidence intervals. Results: A total of 15 studies with 15,995 patients with acute heart failure were included in the final study. Stratifying patients based on a cut-off NLR, we found that high NLR was associated with a significantly higher in-hospital mortality [HR 1.54, 95% CI (1.18–2.00), p < 0.001] and long-term all-cause mortality [HR 1.61, 95% CI (1.40–1.86), p < 0.001] compared to the low-NLR group. Comparing the highest against the lowest NLR quartile, it was shown that patients in the highest NLR quartile has a significantly heightened risk of long-term all-cause mortality [HR 1.77, 95% CI (1.38–2.26), p < 0.001] compared to that of lowest NLR quartile. However, the risks of in-hospital mortality were compared between both quartiles of patients [HR 1.78, 95% CI (0.91–3.47), p = 0.09]. Lastly, NLR values were significantly elevated among non-survivors compared to survivors during index hospitalization [MD 5.07, 95% CI (3.34–6.80), p < 0.001] and during the follow-up period [MD 1.06, 95% CI (0.54–1.57), p < 0.001]. Conclusions: Elevated NLR was associated with an increased risk of short- and long-term mortality and could be a useful tool or incorporated in the risk stratification in patients with acute heart failure.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Patients with Acute Decompensated Heart Failure: A Meta-Analysis

Ang,

Chia,

Jaiswal

et al. 2024

JCM

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Dynamic change of lymphocytes associated with short-term prognosis in anti-MDA5-positive dermatomyositis with interstitial lung disease: a multicenter retrospective study

Tian,

He,

Ren

et al. 2024

Clin Rheumatol

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Lymphopenia is a unique manifestation of anti-MDA5 positive dermatomyositis with interstitial lung disease (MDA5 + DM-ILD). This study aimed to investigate the relationship between dynamic changes in peripheral lymphocytes and short-term prognosis in patients of MDA5 + DM-ILD. Two hundred sixty-three MDA5 + DM-ILD patients were divided into different groups according to lymphocyte count and death or survival within 1 month, then the differences in clinical features and outcomes were compared. Associations between lymphocytes and risk of death within 1 month were also investigated in different lymphocyte groups using Cox proportional hazard models. A generalized additive mixed model (GAMM) was established to analyze the dynamic changes of lymphocytes in the death 1-month group. Lymphocytes of the patients who died within 1 month were significantly lower than survivors by different lymphocyte grouping methods, and the total lymphocytes showed a gradually decreasing trend in non-survivors. And the difference between survivors and non-survivors was more obvious over time. The lowest tertile of baseline lymphocytes as a reference, the hazard ratios for death within 1 month in the highest tertile were 0.497 (95% CI 0.26–0.949, P for trend = 0.033) after adjustment for potential confounders. GAMM analysis found a mean daily decrease of lymphocytes (0.034 × 10^9/L) after admission in death 1-month patients. Low baseline lymphocytes and gradually declined lymphocytes are both associated with a high risk of death within 1 month. However dynamic changes in lymphocytes can better reflect the disease status and better predict the short-term prognosis than baseline lymphocytes in MDA5 + DM-ILD patients. Key points•Low baseline lymphocytes and gradually decreased trend along time correlated with poor short-term prognosis in MDA5 + DM-ILD patients.•Dynamic changes of lymphocytes can better reflect the disease status and better predict the 1-month prognosis than baseline lymphocytes in MDA5 + DM-ILD patients.•Generalized additive mixed model (GAMM) analysis found that in 1-month non-survivors, peripheral blood lymphocytes decreased by 0.034 × 10^9/L per day, while the lymphocytes in survivors gradually increased.

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Association of platelet-to-lymphocyte ratio with 1-year all-cause mortality in ICU patients with heart failure

Hu,

Cheng,

et al. 2024

Sci Rep

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The Platelet-to-Lymphocyte Ratio (PLR) has emerged as a cost-effective biomarker for systemic inflammation and adverse cardiovascular outcomes, yet its prognostic value in critically ill patients with heart failure (HF) remains unclear. Leveraging the MIMIC-IV database, this study investigates the association between PLR and 1-year all-cause mortality in 7,217 ICU patients with HF. Patients were stratified into tertiles (0–126.45, 126.45–252.40, and 252.40–1000), and mortality risk was analyzed using Kaplan-Meier survival curves and Cox proportional hazards models. Elevated PLR was independently associated with higher mortality, with the highest tertile showing a 36% increased risk compared to the lowest (HR 1.36, 95% CI: 1.23–1.50, P < 0.001). Each tertile increment corresponded to a 17% rise in risk. Subgroup analyses revealed stronger associations in hypertensive patients and identified renal dysfunction and red cell distribution width as key modifiers. Integrating PLR with SOFA and APS III scores significantly enhanced predictive accuracy. By reflecting systemic inflammation and immune dysregulation, PLR offers a robust tool for long-term risk stratification and personalized management of ICU patients with HF. These findings highlight the potential of PLR to refine prognostic models, guide clinical decision-making, and improve critical care outcomes. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-024-83583-1.

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Correlation analysis between the static and the changed neutrophil-to-lymphocyte ratio and in-hospital mortality in critical patients with acute heart failure

Cited by 5 publications

References 34 publications

Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Patients with Acute Decompensated Heart Failure: A Meta-Analysis

Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Patients with Acute Decompensated Heart Failure: A Meta-Analysis

Dynamic change of lymphocytes associated with short-term prognosis in anti-MDA5-positive dermatomyositis with interstitial lung disease: a multicenter retrospective study

Association of platelet-to-lymphocyte ratio with 1-year all-cause mortality in ICU patients with heart failure

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