Platelet-lymphocyte ratio and sepsis outcome in children

Abstract

Background Sepsis is the most common cause of death in infants and children worldwide. Identification of patients with a high risk of death and accurately anticipating outcomes in the early phase is very important in order to provide adequate intervention to the patient. Predictors and scoring systems have been used to determine the prognosis of sepsis n children. The platelet-lymphocyte ratio (PLR), a newly-used marker for inflammation, has received recent attention, as it can act as an indicator in a variety of diseases, including sepsis.
 Objective o investigate the relationship between PLR and clinical outcomes in pediatric patients with sepsis.
 Methods This study was conducted using an analytic, observational method with a prospective cohort approach in children with sepsis in the Pediatric Intensive Care Unit (PICU) of Prof. Dr. R. D. Kandou Central General Hospital, Manado, North Sulawesi, from February to August 2020. We analyzed patients’ platelet-lymphocyteratio (PLR), mortality rate, and length of stay using SPSS software. The PLR were recorded once within the first 24 hours of PICU admission.
 Results Of 96 PICU patients, 87 patients were eligible for this study. In total, 50 patients (57.47%) died. Mean PLR was 77.53 among sepsis survivors and 157.2 among non-survivors (rpb=0.566, P<0.0001) indicating a strong relationship between PLR and mortality. We also found a strong positive linear relationship between PLR and PICU length of stay.
 Conclusion Platelet-lymphocyte ratio is a predictor of sepsis outcomes that can be easily and inexpensively checked. Thus, it can be used in regions with limited health facilities.

Prognostic Value of Platelet to Lymphocyte Ratio in Sepsis: A Systematic Review and Meta‐analysis

“…Among the 16 included studies, nine studies had prospective designs. Studies were conducted in China ( n = 4) [ 12 , 22 – 24 ], Indonesia ( n = 3) [ 16 , 19 , 20 ], Turkey ( n = 3) [ 10 , 11 , 18 ], Iran ( n = 1) [ 14 ], Serbia ( n = 1) [ 13 ], Saudi Arabia ( n = 1) [ 9 ], Poland ( n = 1) [ 17 ], Korea ( n = 1) [ 15 ], and India ( n = 1) [ 21 ]. Seven studies reported one-month mortality [ 9 , 10 , 12 , 15 , 19 , 21 , 24 ], three studies reported in-hospital mortality [ 13 , 14 , 22 ], and one study investigated ICU mortality [ 17 ].…”

“…Seven studies reported one-month mortality [ 9 , 10 , 12 , 15 , 19 , 21 , 24 ], three studies reported in-hospital mortality [ 13 , 14 , 22 ], and one study investigated ICU mortality [ 17 ]. Five studies did not report any data in this regard [ 11 , 16 , 18 , 20 , 23 ]. The population in the two studies was septic children [ 16 , 20 ] and in 14 studies were adult septic patients [ 9 – 15 , 17 – 19 , 21 – 24 ].…”

“…Five studies did not report any data in this regard [ 11 , 16 , 18 , 20 , 23 ]. The population in the two studies was septic children [ 16 , 20 ] and in 14 studies were adult septic patients [ 9 – 15 , 17 – 19 , 21 – 24 ]. Seven studies were retrospective [ 9 – 11 , 17 , 18 , 20 , 22 ], and nine were prospective [ 12 – 16 , 19 , 21 , 23 , 24 ].…”

“…The population in the two studies was septic children [ 16 , 20 ] and in 14 studies were adult septic patients [ 9 – 15 , 17 – 19 , 21 – 24 ]. Seven studies were retrospective [ 9 – 11 , 17 , 18 , 20 , 22 ], and nine were prospective [ 12 – 16 , 19 , 21 , 23 , 24 ]. The quality of the studies was high, with scores ranging from 7 to 9.…”

“…Figure 4 shows the subgroup analysis according to the study design. We found seven retrospective studies [ 9 – 11 , 17 , 18 , 20 , 22 ], including 1419 septic patients with 692 survivors and nine prospective studies [ 12 – 16 , 19 , 21 , 23 , 24 ] including 984 septic patients with 557 survivors. Nonsurvivors had elevated levels of PLR compared to survivors in either retrospective (SMD = 0.35, 95% CI = 0.02-0.67, p = 0.035) or prospective studies (SMD = 1.10, 95% CI = 0.35-1.84, p = 0.004).…”