The neutrophil-lymphocyte ratio to predict poor prognosis of critical acute myocardial infarction patients: a retrospective cohort study.

IF 3.8 3区医学 Q1 MEDICAL LABORATORY TECHNOLOGY

Biochemia Medica Pub Date : 2023-02-15 DOI:10.11613/BM.2023.010702

Wenhui Wang, Linlin Liu, Zhongping Ning, Lin Che, Xinming Li

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引用次数: 2

Abstract

Introduction: Inflammation is closely related to adverse outcomes of acute myocardial infarction (AMI). This study aimed to evaluate whether neutrophil-lymphocyte ratio (NLR) can predict poor prognosis of critical AMI patients.

Materials and methods: We designed a retrospective cohort study and extracted AMI patients from the "Medical Information Mart for Intensive Care-III" database. The primary outcome was 1-year all-cause mortality. The secondary outcomes were 90-day and in-hospital all-cause mortalities, and acute kidney injury (AKI) incidence. The optimal cut-offs of NLR were picked by X-tile software according to the 1-year mortality and patient groups were created: low-NLR (< 4.8), high-NLR (4.8 - 21.1), and very high-NLR (> 21.1). Cox and modified Poisson regression models were used to evaluate the effect of NLR on outcomes in critically AMI patients.

Results: Finally, 782 critical AMI patients were enrolled in this study, and the 1-year mortality was 32% (249/782). The high- and very high-NLR groups had a higher incidence of outcomes than the low-NLR group (P < 0.05). The multivariate regression analyses found that the high- and very high-NLR groups had a higher risk of 1-year mortality (Hazard ratio (HR) = 1.59, 95% CI: 1.12 to 2.24, P = 0.009 and HR = 1.73, 95% CI: 1.09 to 2.73, P = 0.020), 90-day mortality (HR = 1.69, 95% CI: 1.13 to 2.54, P = 0.011 and HR = 1.90, 95% CI: 1.13 to 3.20, P = 0.016), in-hospital mortality (Relative risk (RR) = 1.77, 95% CI: 1.14 to 2.74, P = 0.010 and RR = 2.10, 95% CI: 1.23 to 3.58, P = 0.007), and AKI incidence (RR = 1.44, 95% CI: 1.06 to 1.95, P = 0.018 and RR = 1.34, 95% CI: 0.87 to 2.07, P = 0.180) compared with low-NLR group. NLR retained stable predictive ability in sensitivity analyses.

Conclusion: Baseline NLR is an independent risk factor for 1-year mortality, 90-day mortality, in-hospital mortality, and AKI incidence in AMI patients.

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中性粒细胞-淋巴细胞比值预测急性心肌梗死危重患者预后不良:一项回顾性队列研究。

炎症与急性心肌梗死(AMI)的不良结局密切相关。本研究旨在探讨中性粒细胞-淋巴细胞比值(NLR)能否预测急性心肌梗死危重患者的不良预后。材料和方法:我们设计了一项回顾性队列研究，并从“重症监护医疗信息市场- iii”数据库中提取AMI患者。主要终点为1年全因死亡率。次要结局是90天内和院内全因死亡率，以及急性肾损伤(AKI)发生率。采用X-tile软件根据1年病死率选取NLR的最佳临界值，划分低NLR(< 4.8)、高NLR(4.8 ~ 21.1)、极高NLR(> 21.1)患者组。采用Cox和改良泊松回归模型评估NLR对急性心肌梗死危重患者预后的影响。结果:最终纳入782例AMI危重患者，1年死亡率为32%(249/782)。高nlr组和极高nlr组的预后发生率高于低nlr组(P < 0.05)。多元回归分析发现,高收入和非常high-NLR组1年死亡率的风险更高(风险比(人力资源)= 1.59,95% CI: 1.12 ~ 2.24, P = 0.009和HR = 1.73, 95% CI: 1.09 ~ 2.73, P = 0.020), 90天的死亡率(HR = 1.69, 95% CI: 1.13 ~ 2.54, P = 0.011和HR = 1.90, 95% CI: 1.13 ~ 3.20, P = 0.016),住院死亡率(相对危险度(RR) = 1.77, 95% CI: 1.14 ~ 2.74, P = 0.010和RR = 2.10, 95%置信区间CI:1.23 ~ 3.58, P = 0.007)， AKI发生率(RR = 1.44, 95% CI: 1.06 ~ 1.95, P = 0.018, RR = 1.34, 95% CI: 0.87 ~ 2.07, P = 0.180)与低nlr组比较。NLR在敏感性分析中保持稳定的预测能力。结论:基线NLR是AMI患者1年死亡率、90天死亡率、住院死亡率和AKI发生率的独立危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Biochemia Medica 医学-医学实验技术

CiteScore

5.50

自引率

3.00%

发文量

审稿时长

>12 weeks

期刊介绍： Biochemia Medica is the official peer-reviewed journal of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Journal provides a wide coverage of research in all aspects of clinical chemistry and laboratory medicine. Following categories fit into the scope of the Journal: general clinical chemistry, haematology and haemostasis, molecular diagnostics and endocrinology. Development, validation and verification of analytical techniques and methods applicable to clinical chemistry and laboratory medicine are welcome as well as studies dealing with laboratory organization, automation and quality control. Journal publishes on a regular basis educative preanalytical case reports (Preanalytical mysteries), articles dealing with applied biostatistics (Lessons in biostatistics) and research integrity (Research integrity corner).