Neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio predict length of hospital stay in myocarditis

Abstract

Neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) are associated with the severity of various diseases. The aim of this study was to demonstrate the relationship of NLR and MLR with the severity of myocarditis. 202 consecutive patients with myocarditis were retrospectively enrolled in this study. Laboratory parameters and clinical data were extracted from hospital records and discharge letters. Median NLR was 2.48 (IQR 1.55–4.58) and median MLR was 0.42 (IQR 0.39–0.58). NLR and MLR correlated with HF, CRP and leukocyte count, MLR further correlated inversely with LV systolic function (rs = − 0.379, p = 0.030). Both ratios correlated better with length of hospital stay (NLR: rs = 0.435, p = 0.003; MLR: rs = 0.534, p < 0.0001) than CRP, leukocyte count, IL-6 or procalcitonin. AUCs for the prediction of prolonged hospital stay (NLR = 0.75, MLR = 0.80), and optimal cut-offs therefor were calculated. Patients who had in-hospital complications showed a higher NLR, however, this remained statistically insignificant. NLR and MLR correlated with the length of stay, as well as with several clinical and laboratory parameters in patients with myocarditis. Since white blood cell differentials are relatively easy and fast to perform, both ratios could facilitate further risk stratification in affected patients.

Monocyte–Lymphocyte Ratio and Dysglycemia: A Retrospective, Cross-Sectional Study of the Saudi Population

“…This was also confirmed in another study which found that MLR was an independent predictor of long-term major adverse cardiac events in myocardial infarction patients [ 53 ]. A significant correlation between MLR and the length of hospital stay was also reported in myocarditis patients [ 54 ]. Cheng et al have recently shown that elevated MLR was associated with the development of stroke-associated pneumonia and therefore may be exploited for earlier intervention [ 24 ].…”

Monocyte/Lymphocyte Ratio and MCHC as Predictors of Collateral Carotid Artery Disease—Preliminary Report

“…Monocytes and macrophages infiltrating cells in myocarditis play a crucial role in the pathophysiology of the disease. Interestingly, in Mirna et al's study, the MLR correlated with the length of hospital stay with higher predictive characteristics than well-established biomarkers [21].…”

Relationship between preoperative lymphocyte to monocyte ratio and surgery outcome in type A aortic dissection

“…As an independent factor, LMR, which is associated with lymphocytes and monocytes at the same time, reflects two immune pathways that may be less affected by confounding conditions and may be more predictive than monocytes or lymphocytes alone in assessing the prognosis of diseases. LMR had been used to predict adverse events of various cardiovascular diseases ( 8 , 29 , 30 ). However, the potential application value of LMR to provide prognostic information for patients with TAAD remains unclear.…”