Prognostic value of rise in neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in predicting the mortality in paediatric intensive care

Mathews, Siby; Rajan, Aswathy; Soans, Santosh

doi:10.18203/2349-3291.ijcp20191044

Cited by 21 publications

(24 citation statements)

References 31 publications

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“…Mathews et al 15 in their study found that PELOD-2 >20 predicted mortality in 72.2% patients. Based on the ROC curve, PELOD-2 score >16 predicted mortality with a sensitivity 100% and specificity 54.1%.…”

Section: Discussionmentioning

confidence: 89%

Predictive Efficacy of Pediatric Logistic Organ Dysfunction-2 Score in Pediatric Intensive Care Unit of Rural Hospital

Deshmukh

Varma

Damke

et al. 2020

Indian Journal of Critical Care Medicine

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A bstract Aims and objectives Utility of pediatric logistic organ dysfunction-2 (PELOD-2) score on day 1 within 1 hour of admission in predicting mortality in children admitted in pediatric intensive care unit (PICU). Background Various scoring systems aid to evaluate the patient's mortality risk in the intensive care unit (ICU) by assigning a score and predicting the outcome. Critically ill children are characterized by large variations in the normal body homeostasis. These variations can be estimated by the change of the physiological variables from the normal range. Various scores are constructed from deviations of these changed variables. One such score, the PELOD-2 score, is used to predict mortality of patients admitted in PICU. Materials and methods This study was carried out at a tertiary care center in central India to study the utility of PELOD-2 score within 1 hour of admission to predict mortality in patients admitted in PICU. Results Total 129 patients were included in this study with mean age of 67 months. The system with highest admission was central nervous system with 42 children and 16.6% mortality, whereas those 7 patients with hematological system involvement had highest mortality of 28.5%. The mortality rate was 15.55%. In our study for PELOD-2 within 24 hours of admission, the area under receiver operating curve was 0.87 and the Hosmer–Lemeshow test was p = 0.42. Conclusion Pediatric logistic organ dysfunction-2 score in our study had significant association with mortality along with the Hosmer–Lemeshow goodness-of-fit test showing a good prediction of mortality. How to cite this article Deshmukh T, Varma A, Damke S, Meshram R. Predictive Efficacy of Pediatric Logistic Organ Dysfunction-2 Score in Pediatric Intensive Care Unit of Rural Hospital. Indian J Crit Care Med 2020;24(8):701–704.

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Section: Discussionmentioning

confidence: 89%

Predictive Efficacy of Pediatric Logistic Organ Dysfunction-2 Score in Pediatric Intensive Care Unit of Rural Hospital

Deshmukh

Varma

Damke

et al. 2020

Indian Journal of Critical Care Medicine

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“…They also found PELOD-2 score >20 could predict 72.2% of mortality, and high PLR could predict 77.8% mortality cases. 20 In our study, mean PLR value [77.54 (SD 50.08) vs. 157.13 (67.38); P=0.00] and PELOD-2 score [12 (1.32) vs. 14.65 (SD 2.09); P=0.00 were significantly different between survivors and non-survivors. Another study reported that the percentage of patients with PELOD-2 score >7 was significantly higher in non-survivors compared to survivors (96% vs. 3.6%, respectively; OR=649).…”

Section: Discussionmentioning

confidence: 41%

The Platelet-to-lymphocyte ratio, PELOD-2 score, and mortality rate in pediatric sepsis

Rampengan

Joey

Kurniawan

et al. 2021

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Background Sepsis is life-threatening organ dysfunction caused by a regulated immune response to infection. Sepsis remains the most common cause of death in infants and children worldwide. The Pediatric Logistic Organ Dysfunction (PELOD-2) score, one of the most widely used scoring systems in pediatric sepsis patients, has been shown to be accurate in predicting mortality. The platelet-to-lymphocyte ratio (PLR) is a new clinical indicator of inflammation in a variety of diseases including sepsis. Objective To investigate the relationship between PLR, PELOD-2 score, and clinical outcomes in pediatric patients with sepsis. Methods This retrospective cohort study was conducted in the Pediatric Intensive Care Unit (PICU), Prof R.D. Kandou Hospital, Manado, North Sulawesi, from February to August 2020. Subjects’ PELOD-2 score and PLR were recorded once within the first 24 hours of PICU admission. We analyzed patients’ PELOD-2 score, PLR, and mortality rate, with 95% confidence interval (CI) for each value. Results Of 96 children with sepsis admitted to the PICU during the study period, 87 patients (46 boys; 52.9%) met the inclusion criteria. In total, 50 (57.47%) patients were non-survivors. Mean PLR values among survivors [77.54 (SD 50.08)] was significantly lower compared to the values among non-survivors [157.13 (SD 67.38)]; as well as the PELOD-2 score in the survivors group [12 (SD 1.32)] was significantly lower than its value in the non-survivors [14.65 (SD 2.09)]. Spearman’s analysis showed a moderately positive correlation between PLR and PELOD-2 score (r=0.444; 95%CI 0.44 to 1; P<0.01). Biserial point correlation analysis revealed a significant association between PLR and mortality rate (rpb=0.566; P<0.0001),with elevated PLR related to an increased risk of mortality. Conclusion There are positive correlations between PLR, PELOD-2 score, and mortality rate in pediatric patients with sepsis. Higher PLR and PELOD-2 score are associated with higher mortality.

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“…Data have shown that during the early phase of bacterial infection, there is a large increase in the number of platelets in the bloodstream, which then reduces excessively. 12 The lowest lymphocyte value in the sample was 2 and the highest was 39. The patient's lymphocyte mean was 10.3.…”

Section: Discussionmentioning

confidence: 85%

“…Decreased platelet counts in sepsis are associated with an imbalance between central production and peripheral overconsumption of platelets. 11,12 Platelet lymphocyte ratio (PLR) is a value that can be used as a biomarker and can be easily calculated based on a simple laboratory from the results of a complete blood count. The PLR relationship in particular during the systemic inflammatory response was first introduced by Demirag in a patient who had undergone vascular surgery.…”

Section: Introductionmentioning

confidence: 99%

The Correlation of Platelet Lymphocyte Ratio (PLR) as 28 Days Sepsis Mortality Predictor in Intensive Care Unit RSMH Palembang

Shanty¹

2020

JACR

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Introduction. Inflammatory and anti-inflammatory response are important in pathophysiology and mortality of sepsis. Platelet as first line inflammatory marker was found increasing during early phase of infection. Decrease in lymphocyte was caused by disrupted balance between inflammatory and anti-inflammatory response. Platelet-to-lymphocyte ratio (PLR) is a cheap and accessible biomarker of sepsis mortality. This study aims to find the sensitivity and specificity of PLR as mortality predictor of sepsis in 28 days. Method. This observational analytic study with retrospective cohort design was conducted to 91 sepsis patients in intensive care unit of Dr. Mohammad Hoesin Palembang Central Hospital between January and December 2019. Samples were secondarily collected from medical record during June-July 2020. Data was analyzed using chi-square test, cog regression test, and ROC curve analysis. Results. The result found 50 patients (54,9%) died in 28 days. Morbidity score (Charlson) was the only statistically significant mortality parameter (p=0,009). The study reported PLR cut-off point of >272,22. The sensitivity and specificity of PLR as 28-days sepsis mortality predictor are 84% and 80,49% respectively. Conclusion. PLR is alternatively reliable mortality predictor in sepsis patient, accounted to its relatively high sensitivity and specificity.

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Prognostic value of rise in neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in predicting the mortality in paediatric intensive care

Cited by 21 publications

References 31 publications

Predictive Efficacy of Pediatric Logistic Organ Dysfunction-2 Score in Pediatric Intensive Care Unit of Rural Hospital

Predictive Efficacy of Pediatric Logistic Organ Dysfunction-2 Score in Pediatric Intensive Care Unit of Rural Hospital

The Platelet-to-lymphocyte ratio, PELOD-2 score, and mortality rate in pediatric sepsis

The Correlation of Platelet Lymphocyte Ratio (PLR) as 28 Days Sepsis Mortality Predictor in Intensive Care Unit RSMH Palembang

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