Neutrophil-to-lymphocyte ratio for the assessment of hospital mortality in patients with acute pulmonary embolism

Abstract

IntroductionNeutrophil-to-lymphocyte ratio (NLR), which is an essential marker of inflammation, has been shown to be associated with adverse outcomes in various cardiovascular diseases in the literature. In this study we sought to evaluate the association between NLR and prognosis of acute pulmonary embolism (APE).Material and methodsWe retrospectively evaluated blood counts and clinical data of 142 patients with the diagnosis of pulmonary embolism (PE) from Ondokuz Mayis University Hospital between January 2006 and December 2012. The patients were divided into two groups according to NLR: NLR < 4.4 (low NLR group, n = 71) and NLR ≥ 4.4 (high NLR group, n = 71).ResultsMassive embolism (66.2% vs. 36.6%, p < 0.001) and in-hospital mortality (21.1%, 1.4%, p < 0.001) were higher in the high NLR group. In multivariate regression analysis NLR ≥ 5.7, systolic blood pressure (BP) < 90 mm Hg, serum glucose > 126 mg/dl, heart rate > 110 beats/min, and PCO2 < 35 or > 50 mm Hg were predictors of in-hospital mortality. The optimal NLR cutoff value was 5.7 for mortality in receiver operating characteristic (ROC) analysis. Having an NLR value above 5.7 was found to be associated with a 10.8 times higher mortality rate than an NLR value below 5.7.ConclusionsIn patients presenting with APE, NLR value is an independent predictor of in-hospital mortality and may be used for clinical risk classification.

Prognostic Value of the Neutrophil–Lymphocyte and Platelet– Lymphocyte Ratios in Predicting One-Year Mortality in Patients with Hip Fractures and Aged Over 60 Years

“…A high correlation has been detected between the NLR and acute coronary syndrome, non-ST myocardial infarcts, ischemic and hemorrhag-ic strokes, pulmonary embolisms, and several types of cancer (5)(6)(7), while the platelet-lymphocyte ratio (PLR) is calculated through the division of absolute platelet count by lymphocyte count. The PLR has been claimed to have potential as a marker to help identify thrombotic activity and inflammation in certain oncological and cardiac diseases (8,9).…”

The effect of neutrophil/lymphocyte ratio on 1-year mortality in pulmonary embolism diagnosed patients

“…In a study by Lee et al [38], one-month mortality was not statistically significant in terms of mortality when embolism was center or pivotal. On the contrary, Jain et al [41] in 2016 showed that 90-d mortality of patients with submassive embolism was statistically significantly higher than massive embolism. In our study, the 1-y mortality of patients with massive embolism was found to be statistically higher than that of patients with submassive embolism.…”

Prognostic role of the preoperative neutrophil-to-lymphocyte ratio and albumin for 30-day mortality in patients with postoperative acute pulmonary embolism

“…The NLR is the comprehensive presentation of systemic in ammation and the balance between neutrophils and lymphocytes in CBCs. Previous studies have shown that an elevated NLR is associated with an increased rate of hospital mortality among patients with acute pulmonary embolism [13], acute exacerbation of chronic obstructive pulmonary disease [21], and acute type A aortic dissection [22]; of 30-day mortality among patients with acute pulmonary embolism [19], acute kidney injury [23], ST-elevation myocardial infarction [24], and intracerebral hemorrhage [25,26]; and of long-term mortality among patients with STelevation myocardial infarction [27], breast cancer [28] and epithelial ovarian cancer [29].…”

“…The mechanism of in ammatory reactions is closely related to the occurrence and development of thromboembolism [10]. In recent years, many researchers have reported that some predictors based on in ammation are associated with prognosis in patients with pulmonary embolism, such as the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), red blood cell distribution width (RDW), and C-reactive protein (CRP) [11][12][13][14]. In addition, the relationship between nutritional status and prognosis in patients with pulmonary embolism has also been extensively studied in a previous study [15].…”