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

Abstract

The goal of this study was to conduct a systematic review of the literature on the relationship between peripheral blood platelet to lymphocyte ratio (PLR) and mortality in sepsis and to integrate the findings in a meta-analysis. An electronic search of three main databases was performed: PubMed, Embase, and Scopus on 19 December 2021. Finally, 16 studies comprising 2403 septic patients, including 1249 survivors and 1154 nonsurvivors, were included in this meta-analysis. We found that PLR levels were significantly higher in nonsurvivors than in survivors (random effect model: SMD = 0.72 , 95% CI; 0.35–1.10, p < 0.001 ). However, significant heterogeneity was observed across the studies ( I 2 = 94.1 % , p < 0.01 ). So, we used random effect model in our meta-analysis. In the subgroup analysis, according to mortality time, patients deceased during one month after sepsis had elevated levels of PLR compared to survivors ( SMD = 1.03 , 95% CI = 0.15 -1.92, p = 0.22 ). However, in-hospital mortality was not associated with PLR level ( SMD = 0.41 , 95% CI = − 0.18 -0.99, p = 0.175 ). Our findings support PLR to be a promising biomarker that can be readily integrated into clinical settings to aid in the prediction and prevention of sepsis mortality.

Key factors predicting the in‐hospital mortality of patients with severe cutaneous adverse reactions in Thailand

“…Therefore, a high platelet-tolymphocyte ratio (PLR) is a promising biomarker for predicting sepsis severity. 20,21 As information from a complete blood count could be helpful in predicting the severity and mortality of various inflammatory disorders, while the prognostic factors in SCARs are still unclear or rely on integrated clinical and laboratory parameters, our study aims to explore whether the data from a basic laboratory assessment could help to predict the HMR in SCAR patients of all phenotypes.…”

“…Platelet activation also plays a role in the worsening coagulation disorders in systemic inflammatory reactions, and lymphopenia could reflect the immunosuppressive status in severe infections. Therefore, a high platelet‐to‐lymphocyte ratio (PLR) is a promising biomarker for predicting sepsis severity 20,21 …”

Exogenous administration of appropriate dose of IL-17A helps to improve multiple organ dysfunction and improve survival in septic mice

“…This is also consistent with our results. In addition, a meta-analysis on the prognostic value of PLR in sepsis [39] showed that high PLR predicts worse prognosis. These are consistent with our results.…”

OCT-Based Biomarkers are Associated with Systemic Inflammation in Patients with Treatment-Naïve Diabetic Macular Edema

“…NLR is now widely used in all medical disciplines and is considered to be able to reflect body’s reaction to various external or internal stimuli, and the normal value of NLR was considered to be 1.0–2.0 [ 51 ]. Similarly, PLR also showed potential value in multiple diseases [ 52 , 53 ] and the normal value of PLR was 70–200 [ 51 ]. These indices are calculated from common blood cell count, and the mechanisms behind them are thought to be results of cell functions, including those of neutrophils, lymphocytes, and platelets.…”