Late Mortality Prediction of Neutrophil-to-Lymphocyte and Platelet Ratio in Patients With Trauma Who Underwent Emergency Surgery: A Retrospective Study

Chae, Yun Jeong; Lee, Jiyoung; Park, Ji Hyun; Han, Do-Gyun; Ha, Eun Ju; Yi, In Kyong

doi:10.1016/j.jss.2020.11.088

Cited by 15 publications

(17 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies focusing on NLR and PLR in predicting patient outcomes after abdominal trauma are lacking. Table 8 summarizes the role of these ratios in other traumatic injury [27,28,[30][31][32][35][36][37][38]. Jo et al [31] demonstrated that PLR was an independent predictive marker in adult patients with road traffic injuries.…”

Section: Discussionmentioning

confidence: 99%

“…Chae et al [35] studied the prognostic value of the NLR and the neutrophil-to-lymphocyte platelet (NLPR) ratios among the adult trauma patients who underwent emergency surgery. This study concluded that NLPR, as a reflection of the systemic inflammatory condition, at day 7 was a superior predictor of late mortality than the other trauma scores.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Platelet-Lymphocyte and Neutrophil-Lymphocyte Ratio for Prediction of Hospital Outcomes in Patients with Abdominal Trauma

El‐Menyar

Mekkodathil

Alansari

et al. 2022

BioMed Research International

View full text Add to dashboard Cite

Background. The platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) reflect the patient inflammatory and immunity status. We investigated the role of on-admission PLR and NLR in predicting massive transfusion protocol (MTP) activation and mortality following abdominal trauma. Methods. A 4-year retrospective analysis of all adult abdominal trauma patients was conducted. Patients were classified into survivors and nonsurvivors and low vs. high PLR. The discriminatory power for PLR and NLR to predict MTP and mortality was determined. Multivariate logistic regression analysis was performed for predictors of mortality. Results. A total of 1199 abdominal trauma patients were included (18.7% of all the trauma admissions). Low PLR was associated with more severe injuries and greater rates of hospital complications including mortality in comparison to high PLR. On-admission PLR and NLR were higher in the survivors than in nonsurvivors (149.3 vs. 76.3 ( p = 0.001 ) and 19.1 vs. 13.7 ( p = 0.009 ), respectively). Only PLR significantly correlated with injury severity score, revised trauma score, TRISS, serum lactate, shock index, and FASILA score. Optimal cutoffs of PLR and NLR for predicting mortality were 98.5 and 18.5, respectively. The sensitivity and specificity of PLR were 81.3% and 61.1%, respectively, and 61.3% and 51.3%, respectively, for NLR. The AUROC for predicting MTP was 0.69 (95% CI: 0.655–0.743) for PLR and 0.55 (95% CI: 0.510–0.598) for NLR. To predict hospital mortality, the area under the curve (AUROC) for PLR was 0.77 (95% CI: 0.712–0.825) and 0.59 (95% CI: 0.529–0.650) for the NLR. On multivariate logistic regression analysis, the age, Glasgow Coma Scale, sepsis, injury severity score, and PLR were independent predictors of mortality. Conclusion. On-admission PLR but not NLR helps early risk stratification and timely management and predicts mortality in abdominal trauma patients. Further prospective studies are required.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Platelet-Lymphocyte and Neutrophil-Lymphocyte Ratio for Prediction of Hospital Outcomes in Patients with Abdominal Trauma

El‐Menyar

Mekkodathil

Alansari

et al. 2022

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…Moreover, recent research presented that the levels of postoperative N/LP were significantly associated with AKI after abdominal and cardiovascular surgery ( 12 , 13 , 32 ). In addition, several retrospective studies have also indicated that a rising N/LP ratio is an efficient predictor of the risk of in-hospital mortality in patients with S-AKI and those undergoing emergency surgery ( 14 , 33 ). However, no study has reported the relationship between N/LP and the occurrence and severity of AKI in sepsis patients.…”

Section: Discussionmentioning

confidence: 99%

Influence of the Initial Neutrophils to Lymphocytes and Platelets Ratio on the Incidence and Severity of Sepsis-Associated Acute Kidney Injury: A Double Robust Estimation Based on a Large Public Database

Xiao

Liu

et al. 2022

Front. Immunol.

View full text Add to dashboard Cite

BackgroundAcute kidney injury (AKI) is a frequent consequence of sepsis and has been linked to poor prognosis. In critically ill patients, the ratio of neutrophils to lymphocytes and platelets (N/LP) has been confirmed as an inflammation-related marker connected with the development of renal dysfunction. However, the effect of the N/LP ratio on the initiation and development of AKI in patients with sepsis remained unclear. The purpose of this study was to determine if the N/LP ratio on intensive care unit (ICU) admission was associated with the occurrence of sepsis-associated AKI (S-AKI) and severe AKI.MethodsAdult septic patients from the Medical Information Mart for Intensive Care-IV database were screened and classified into three categories (low, middle, or high) based on their N/LP ratio quartiles. The Cox proportional hazard and competing risk models were used to determine the risk of S-AKI in various N/LP groups, whilst the logistic regression model and restricted cubic splines (RCS) analysis were employed to investigate the link between N/LP ratios and the occurrence of severe AKI. Finally, we did a doubly robust estimation, a subgroup analysis, and a sensitivity analysis to determine the findings’ robustness.ResultsWe categorized 485, 968, and 485 septic patients into three groups based on their N/LP ratios: low, intermediate, and high. According the Cox proportional hazard model, the hazard rate (95% CI) for those in the middle and high N/LP groups on the incidence of S-AKI were 1.30(1.07, 1.58) and 1.27(1.02, 1.59), respectively, as compared to those in the low N/LP group. And the Fine-Gray proportional subdistribution hazards model indicated that mortality was not a substantial competing risk for S-AKI. Additionally, multivariate logistic regression revealed that the risk of severe AKI increased 1.83 fold in the high group compared to the low group. The RCS result also suggested that the probability of severe AKI rose significantly when N/LP > 9.5. The consistency of these findings was confirmed using doubly robust estimation. However, subgroup and sensitivity analyses revealed that the association between N/LP and the incidence of S-AKI, severe AKI varied considerably between different populations and diagnostic criteria.ConclusionA raised initial N/LP level may induce the development of S-AKI and severe AKI within 7 days after ICU admission in septic patients. These influences were enhanced in elder, male, septic shock, and those with poor health condition. Furthermore, high NLP was more strongly connected to the risk of S-AKI and severe AKI in sepsis patients on the urine output-based AKI criteria than on the serum creatinine-based criteria.

show abstract

“…We included a novel CBC‐based index, NMLPR, in the final clinical scoring system, which strongly correlated with postoperative mortality risk. NMLPR is a composite index of NLR × MPR, both of which are known predictors of postoperative and other disease‐related mortalities 12,14–16,32–34 . The use of composite indices offers two main advantages: (1) they compress information and (2) increase the diagnostic and prognostic specificity of individual biomarkers.…”

Section: Discussionmentioning

confidence: 99%

“…Systemic inflammation is associated with alterations in the counts of these blood cells, and it often manifests as neutrophilia, lymphopenia, and thrombocytopenia 9–11 . Several studies have revealed significant associations between such alterations and postoperative mortality 12–16 . Moreover, albumin is a negative acute phase reactant that is downregulated during inflammation, irrespective of the patient’s nutritional state 17,18 .…”

Section: Introductionmentioning

confidence: 99%

A risk scoring system integrating postoperative factors for predicting early mortality after major non‐cardiac surgery

Chae

Kim

et al. 2022

Clinical Translational Sci

View full text Add to dashboard Cite

We aimed to develop a risk scoring system for 1-week and 1-month mortality after major non-cardiac surgery, and assess the impact of postoperative factors on 1-week and 1-month mortality using machine learning algorithms. We retrospectively reviewed the medical records of 21,510 patients who were transfused with red blood cells during non-cardiac surgery and collected pre-, intra-, and postoperative features. We derived two patient cohorts to predict 1-week and 1-month mortality and randomly split each of them into training and test cohorts at a ratio of 8:2. All the modeling steps were carried out solely based on the training cohorts, whereas the test cohorts were reserved for the evaluation of predictive performance. Incorporation of postoperative information demonstrated no significant benefit in predicting 1-week mortality but led to substantial improvement in predicting 1-month mortality. Risk scores predicting 1-week and 1-month mortality were associated with area under receiver operating characteristic curves of 84.58% and 90.66%, respectively. Brain surgery, amount of intraoperative red blood cell transfusion, preoperative platelet count, preoperative serum albumin, and American Society of Anesthesiologists physical status were included in the risk score predicting 1-week mortality. Postoperative day (POD) 5 (neutrophil count × mean platelet volume) to (lymphocyte count × platelet count) ratio, preoperative and POD 5 serum albumin, and occurrence of acute kidney injury were included in the risk score predicting 1-month mortality. Our scoring system advocates the importance of postoperative complete blood count differential and serum albumin to better predict mortality beyond the first week post-surgery. Study Highlights WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?Postoperative mortality accounts for 7.7% of all-cause mortality and is the third greatest contributor to death. Hence, risk stratification and prediction of | 2231

show abstract

Late Mortality Prediction of Neutrophil-to-Lymphocyte and Platelet Ratio in Patients With Trauma Who Underwent Emergency Surgery: A Retrospective Study

Cited by 15 publications

References 29 publications

Platelet-Lymphocyte and Neutrophil-Lymphocyte Ratio for Prediction of Hospital Outcomes in Patients with Abdominal Trauma

Platelet-Lymphocyte and Neutrophil-Lymphocyte Ratio for Prediction of Hospital Outcomes in Patients with Abdominal Trauma

Influence of the Initial Neutrophils to Lymphocytes and Platelets Ratio on the Incidence and Severity of Sepsis-Associated Acute Kidney Injury: A Double Robust Estimation Based on a Large Public Database

A risk scoring system integrating postoperative factors for predicting early mortality after major non‐cardiac surgery

Contact Info

Product

Resources

About