Background: To investigate the association between both neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) and 30-day mortality in patients hospitalized for an episode of acute decompensated heart failure (ADHF).
Methods: 439 patients admitted to emergency department (ED) for an episode of ADHF. Clinical history, demographic, clinical and laboratory data recorded at ED admission and then correlated with 30-day mortality.
Results: 45/439 (10.3%) patients died within 30 days from ED admission. The median values of NLR (4.1 vs 11.7) and PLR (159.1 vs 285.9) were significantly lower in survivors than in patients who died. The area under the ROC curve of NLR was significantly higher than that of the neutrophil count (0.76 vs 0.59; p<0.001), whilst the AUC of PLR was significantly better than that of the platelet count (0.71 vs 0.51; p<0.001). In univariate analysis, both NLR and PLR were significantly associated with 30-day. In the fully-adjusted multivariate model, NLR (odds ratio, 3.63) and PLR (odds ratio, 3.22) remained independently associated with 30-day mortality after ED admission.
Conclusions: Routine assessment of NLR and PLR at ED admission may be a valuable aid to complement other conventional measures for assessing the medium-short risk of ADHF patients.
Uvod: Svrha rada je bila da se ispitaju odnosi povezanosti između neutrofila prema limfocitima (NLR) i trombocita prema limfocitima (PLR) i 30-dnevna smrtnost kod pacijenata koji su hospitalizovani zbog akutnog dekompenzovanog srčanog oštećenja (ADHF).
Metode: U odeljenje hitne medicine (ED) primljeno je 439 pacijenata sa ADHF. Istorija bolesti, demografski i laboratorijski podaci su praćeni prilikom prijema u ED i upoređivani su sa 30-dnevnom smrtnošću.
Rezultati: U toku 30 dana od prijema u ED umrlo je 45/439 (10,33%) pacijenata. Srednje vrednosti NLR (4,11 vs, 11,7) i PLR (159,1 vs 285,9) bile su značajno niže kod preživelih u odnosu na preminule pacijente. Površina ispod ROC krive u NLR bila je značajno viša nego kod iste u broju neutrofila (0,76 vs 0,59; p < 0,001), dok je AUC u slučaju PLR bio značajno bolji nego u odnosu na broj trombocita (0,71 vs 0,51; p < 0,001). Univarijantne analize u slučaju oba NLR iPLR bile su značajno povezane za 30-danom. U potpuno podešenom multivarijantnom modelu, NLR (Odds odnos, 2,63) i PLR (Odds odnos, 3,22) bili su nezavisno povezani sa 30-dnevnom smrtnošću posle prijema u ED.
Zaključak: Rutinsko praćenje NLR i PLR pri ED prijemu može da bude veoma značajna pomoć uz druga konvencionalna merenja i praćenja radi umanjenja rizika kod ADHF pacijenata.
Keywords: acute heart failure; lymphocytes; monocytes; mortality; platelets.