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Chuang SH, Chang CH. Inflammatory Markers in Thyroid Eye Disease: A Meta-Analysis. Endocr Res 2024:1-10. [PMID: 38869186 DOI: 10.1080/07435800.2024.2362787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 05/28/2024] [Indexed: 06/14/2024]
Abstract
Thyroid Eye Disease (TED) is an inflammatory autoimmune condition affecting the eyes, often associated with Graves' disease. Inflammation is important in TED, involving immune cells and orbital tissues. While inflammatory markers have been studied in other diseases, their role in TED is unclear. We included 734 participants from 5 eligible studies investigated associations between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) and TED. Initial analysis found no significant differences in these markers between TED and control groups. However, sensitivity analysis excluding an outlier study revealed significant differences in NLR, PLR, and MLR between groups, suggesting the potential association between these inflammatory markers and TED. More research is needed, but these findings indicate complex TED pathogenesis and that inflammation may offer insights for TED diagnosis and management.
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Affiliation(s)
- Shu-Han Chuang
- Division of General Practice, Department of Medical Education, Changhua Christian Hospital, Changhua, Taiwan R O C
| | - Cheng-Hsien Chang
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan R O C
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan R O C
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Regassa DA, Nagaash RS, Habtu BF, Haile WB. Diagnostic significance of complete blood cell count and hemogram-derived markers for neonatal sepsis at Southwest Public Hospitals, Ethiopia. World J Clin Pediatr 2024; 13:92392. [DOI: 10.5409/wjcp.v13.i2.92392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/11/2024] [Accepted: 04/12/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Neonatal sepsis is defined as an infection-related condition characterized by signs and symptoms of bacteremia within the first month of life. It is the leading cause of mortality and morbidity among newborns. While several studies have been conducted in other parts of world to assess the usefulness of complete blood count parameters and hemogram-derived markers as early screening tools for neonatal sepsis, the associations between sepsis and its complications with these blood parameters are still being investigated in our setting and are not yet part of routine practice.
AIM To evaluate the diagnostic significance of complete blood cell count hemogram-derived novel markers for neonatal sepsis among neonates attending public hospitals in the southwest region of Oromia, Ethiopia, through a case control study.
METHODS A case control study was conducted from October 2021 to October 2023 Sociodemographic, clinical history, and laboratory test results data were collected using structured questionnaires. The collected data were entered into Epi-data 3.1 version and exported to SPSS-25 for analysis. Chi-square, independent sample t-test, and receiver operator characteristics curve of curve were used for analysis. A P-value of less than 0.05 was considered statistically significant.
RESULTS In this study, significant increases were observed in the following values in the case group compared to the control group: In white blood cell (WBC) count, neutrophils, monocyte, mean platelet volume (MPV), neutrophils to lymphocyte ratio, monocyte to lymphocyte ratio (MLR), red blood cell width to platelet count ratio (RPR), red blood width coefficient variation, MPV to RPR, and platelet to lymphocyte ratio. Regarding MLR, a cut-off value of ≥ 0.26 was found, with a sensitivity of 68%, a specificity of 95%, a positive predictive value (PPV) of 93.2%, and a negative predictive value (NPV) of 74.8%. The area under the curve (AUC) was 0.828 (P < 0.001). For WBC, a cut-off value of ≥ 11.42 was identified, with a sensitivity of 55%, a specificity of 89%, a PPV of 83.3%, and a NPV of 66.4%. The AUC was 0.81 (P < 0.001). Neutrophils had a sensitivity of 67%, a specificity of 81%, a PPV of 77.9%, and a NPV of 71.1%. The AUC was 0.801, with a cut-off value of ≥ 6.76 (P = 0.001). These results indicate that they were excellent predictors of neonatal sepsis diagnosis.
CONCLUSION The findings of our study suggest that certain hematological parameters and hemogram-derived markers may have a potential role in the diagnosis of neonatal sepsis.
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Affiliation(s)
- Dereje Abebe Regassa
- Department of Medical Laboratory Sciences, Wolkite University, Wolkite 11330, Ethiopia
| | - Rahel Shumi Nagaash
- Department of Medical Laboratory Sciences, Wolkite University, Wolkite 11330, Ethiopia
| | - Bisirat Fikadu Habtu
- Department of Medical Laboratory Sciences, Wolkite University, Wolkite 11330, Ethiopia
| | - Woyesa Beyene Haile
- Department of Medical Laboratory Sciences, Dire Dawa University, Dire Dawa 3000, Ethiopia
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Zhang Y, Feng L, Zhu Z, He Y, Li X. Association between blood inflammatory indices and heart failure: a cross-sectional study of NHANES 2009-2018. Acta Cardiol 2024:1-13. [PMID: 38771356 DOI: 10.1080/00015385.2024.2356325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 05/12/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Inflammation plays a pivotal role in the pathogenesis of heart failure (HF). This study was aimed to the potential association between complete blood cell count (CBC)-derived inflammatory biomarkers and HF. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018 were utilised. We evaluated the associations between HF and five systemic inflammation markers derived from CBC: systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR). Demographic characteristics, physical examinations, and laboratory data were systematically collected for comparative analysis between HF and non-HF individuals. Fitted smoothing curves and threshold effect analysis delineated the relationship. In addition, Spearman correlation and subgroup analyses were further conducted. RESULTS A total of 26,021 participants were categorised into HF (n = 858) and non-HF (n = 25,163) groups. After adjusting for confounding variables, SIRI, NLR, and MLR had significant positive correlations with the risk of HF. Participants in the highest quarter groups of SIRI, NLR, and MLR showed a increased risk of developing HF compared to those in the lowest quarter group. Furthermore, subgroup and sensitivity analyses indicated that SIRI, NLR, and MLR had a stronger correlation to HF (all p < 0.05). Smoothing curve fitting highlighted a nonlinear relationship between CBC-derived inflammatory biomarkers and HF. CONCLUSIONS Our results illustrated a significant association between elevated levels of SIRI, NLR, and MLR and an increased risk of HF. SIRI, NLR, and MLR could potentially serve as systemic inflammation hazard markers for HF.
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Affiliation(s)
- Yayun Zhang
- Department of Cardiovascular Medicine, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Lu Feng
- Department of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Zixiong Zhu
- Department of Cardiovascular Medicine, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Yubin He
- Department of Cardiovascular Medicine, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Xuewen Li
- Department of Cardiovascular Medicine, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
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Bacârea A, Coman O, Bacârea VC, Văsieşiu AM, Săplăcan I, Fodor RŚ, Grigorescu BL. Immune profile of patients‑a new approach in management of sepsis and septic shock? Exp Ther Med 2024; 27:203. [PMID: 38590571 PMCID: PMC11000046 DOI: 10.3892/etm.2024.12489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/29/2024] [Indexed: 04/10/2024] Open
Abstract
The present study was a prospective observational single center study, enrolling 102 patients with sepsis, admitted in the Intensive Care Unit of the County Emergency Clinical Hospital in Târgu Mureș (Mureș, Romania). The main goal of the present study was to compare the changes of the following parameters on day 1 compared with day 5, in sepsis compared with septic shock, as well as in survivors compared with non-survivors: Cell blood count parameters, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic inflammation index, C reactive protein (CRP), ferritin, procalcitonin (PCT), CD 3+ T cells, CD4+ T cells, CD8+ T cells, CD16+CD56+/CD3-NK cells and CD19+ B cells. The relationship between the subcategories of lymphocytes with the inflammatory markers was evaluated. The serum concentration of CRP and PCT was significantly lower on day 5 compared with day 1 and serum ferritin was significantly higher in patients with septic shock. The percentage of cytotoxic T lymphocytes was significantly decreased and the percentage of NK lymphocytes was significantly increased in patients who developed septic shock. The results indicated a negative significant correlation between the proportion of T lymphocytes and PCT concentration and a positive significant correlation between the proportion of B lymphocytes and PCT concentration.
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Affiliation(s)
- Anca Bacârea
- Department of Pathophysiology, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, Târgu Mureș, Mureș 540142, Romania
| | - Oana Coman
- Department of Simulation Applied in Medicine, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, Târgu Mureș, Mureș 540142, Romania
| | - Vladimir Constantin Bacârea
- Department of Scientific Research Methodology, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, Târgu Mureș, Mureș 540142, Romania
| | - Anca Meda Văsieşiu
- Department of Infectious Disease, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, Târgu Mureș, Mureș 540142, Romania
| | - Irina Săplăcan
- Clinic of Anesthesiology and Intensive Care, Emergency County Hospital, Târgu Mureș, Mureș 540136, Romania
| | - Raluca Śtefania Fodor
- Department of Anesthesiology and Intensive Therapy, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, Târgu Mureș, Mureș 540142, Romania
| | - Bianca Liana Grigorescu
- Department of Anesthesiology and Intensive Therapy, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, Târgu Mureș, Mureș 540142, Romania
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Martinez JM, Espírito Santo A, Ramada D, Fontes F, Medeiros R. Diagnostic accuracy of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and neutrophil-lymphocyte-to-platelet ratio biomarkers in predicting bacteremia and sepsis in immunosuppressive patients with cancer: literature review. Porto Biomed J 2024; 9:254. [PMID: 38835655 PMCID: PMC11146520 DOI: 10.1097/j.pbj.0000000000000254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/23/2024] [Accepted: 05/05/2024] [Indexed: 06/06/2024] Open
Abstract
Background This literature review explores the role of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and neutrophil-lymphocyte-to-platelet ratio (NLPR) biomarkers, as potential indicators for predicting bacteremia and sepsis in patients with cancer. Objective Tracing the evolution of interest in this area since 2001, the aim of this review was to report a comprehensive overview of current knowledge and gaps, particularly in patients undergoing immunosuppression. Summary of Findings The literature research indicates the potential of NLR, PLR, and other biomarkers in diagnosing and predicting sepsis, with some studies emphasizing their value in mortality prediction. A specific focus on bacteremia shows the effectiveness of NLR and PLR as early indicators and prognostic tools, though mostly in noncancer patient populations. While NLR and PLR are promising in general cancer patient populations, the review addresses the challenges in applying these biomarkers to patients with neutropenic and lymphopenic cancer. The NLPR could be considered a significant biomarker for inflammation and mortality risk in various medical conditions, yet its diagnostic accuracy in patients with immunosuppressed cancer is not extensively validated. Conclusion This review offers a snapshot of the current research on biomarkers in patients with immunocompromised cancer in the sepsis and bacteremia area. More focused research on their application is necessary. This gap underscores an opportunity for future studies to enhance diagnostic and prognostic capabilities in this high-risk group.
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Affiliation(s)
- Jose Manuel Martinez
- Oncology Clinical Research Unit IPO Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal
| | - Ana Espírito Santo
- Oncology Clinical Research Unit IPO Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal
| | - Diana Ramada
- Oncology Nursing Research Unit IPO Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal
| | - Filipa Fontes
- Approach to Precursor Lesions and Early Cancer Research Unit IPO Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal
- Public Health Department and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group Research Unit IPO Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal
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Nourigheimasi S, Yazdani E, Ghaedi A, Khanzadeh M, Lucke-Wold B, Dioso E, Bazrgar A, Ebadi M, Khanzadeh S. Association of inflammatory biomarkers with overall survival in burn patients: a systematic review and meta-analysis. BMC Emerg Med 2024; 24:76. [PMID: 38684973 PMCID: PMC11057161 DOI: 10.1186/s12873-024-00988-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 04/15/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION The inflammatory response to burn injuries can lead to organ dysfunction that ultimately results in increased mortality and morbidity. This meta-analysis was conducted to determine the efficacy of inflammatory biomarkers, including the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), procalcitonin (PCT), and C-reactive protein (CRP) as predictive tools of mortality among burn patients. MATERIAL AND METHODS The biomarker levels of survivors and non-survivors were consolidated according to guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Three main databases were searched electronically: PubMed, Web of Science, and Scopus, on December 8, 2022. The Newcastle-Ottawa Quality Assessment Scale (NOS) was used to evaluate and score the methodological quality of the included studies. The standard mean difference (SMD) with a 95% confidence interval (CI) was utilized. RESULTS Twenty-four studies were included in our systematic review and meta-analysis, (3636 total burn patients), of whom 2878 survived. We found that deceased burn patients had elevated levels of NLR (SMD = 0.60, 95% CI; 0.19-1.00, P < 0.001), CRP (SMD = 0.80, 95% CI; 0.02-1.58, P = 0.04), and PCT (SMD = 0.85, 95% CI; 0.45-1.24, P < 0.001), compared to survivors. However, we found no association between PLR and mortality among burn patients (SMD = 0.00, 95% CI; -0.14-0.15, P < 0.001). In addition, CRP was significantly higher in non-survivors (SMD = 0.80, 95% CI; 0.02-1.58, P =0.04). Similar results were also found about PCT (SMD = 0.85, 95% CI; 0.45-1.24, P < 0.001). When we analyzed the PCT data, collected in the first 24-48 hours, we found similar results; the PCT level was significantly higher in non-survivors in the immediate postinjury-period (SMD = 0.67, 95% CI; 0.31-1.02, P < 0.001). There was no publication bias among studies on the role of NLR in burn (Egger's test P = 0.91). The based cut-off values for NLR (13), CRP (71), and PCT (1.77) yielded sensitivities of 69.2%, 100%, and 93.33%, and specificities of 76%, 72.22%, and 72.22% respectively. DISCUSSION/CONCLUSIONS PCT is a marker of sepsis, therefore its elevated level is presumably associated with a higher incidence and severity of sepsis among non-survivors. In addition, NLR and CRP are promising biomarkers for predicting and guiding prevention against burn deaths in clinical settings.
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Affiliation(s)
| | - Erfan Yazdani
- Medical School, Islamic Azad University, Tonekabon Branch, Tonekabon, Iran
| | - Arshin Ghaedi
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Monireh Khanzadeh
- Geriatric & Gerontology Department, Medical School, Tehran University of Medical and Health Sciences, Tehran, Iran
| | | | | | - Aida Bazrgar
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Vitiello R, Smimmo A, Matteini E, Micheli G, Fantoni M, Ziranu A, Maccauro G, Taccari F. Systemic Inflammation Response Index (SIRI) and Monocyte-to-Lymphocyte Ratio (MLR) Are Predictors of Good Outcomes in Surgical Treatment of Periprosthetic Joint Infections of Lower Limbs: A Single-Center Retrospective Analysis. Healthcare (Basel) 2024; 12:867. [PMID: 38727424 PMCID: PMC11083165 DOI: 10.3390/healthcare12090867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/11/2024] [Accepted: 04/21/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Periprosthetic joint infection (PJI) is a devastating complication that develops after total joint arthroplasty (TJA), whose incidence is expected to increase over the years. Traditionally, surgical treatment of PJI has been based on algorithms, where early infections are preferably treated with debridement, antibiotics, and implant retention (DAIR) and late infections with two-stage revision surgery. Two-stage revision is considered the "gold standard" for treatment of chronic prosthetic joint infection (PJI) as it enables local delivery of antibiotics, maintenance of limb-length and mobility, and easier reimplantation. Many studies have attempted to identify potential predicting factors for early diagnosis of PJI, but its management remains challenging. In this observational retrospective study, we investigated the potential role of inflammatory blood markers (neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), systemic inflammatory response index (SIRI), and aggregate index of systemic inflammation (AISI)) as prognostic factors in two-stage exchange arthroplasty for PJI. METHODS A single-center retrospective analysis was conducted, collecting clinical data and laboratory parameters from patients submitted to prosthetic explantation (EP) for chronic PJI. Laboratory parameters (PCR, NLR, MLR, PLR, SIRI, SII, and AISI) were evaluated at the explantation time; at 4, 6, and 8 weeks after surgery; and at reimplantation time. The correlation between laboratory parameters and surgery success was evaluated and defined as infection absence/resolution at the last follow-up. RESULTS A total of 57 patients with PJI were evaluated (62% males; average age 70 years, SD 12.14). Fifty-three patients with chronic PJI were included. Nine patients underwent DAIR revision surgery and chronic suppressive therapy; two patients died. Nineteen patients completed the two-stage revision process (prosthetic removal, spacer placement, and subsequent replanting). Among them, none showed signs of reinfection or persistence of infection at the last available follow-up. The other twenty-three patients did not replant due to persistent infection: among them, some (the most) underwent spacer retention; others (fewer in number) were submitted to resection arthroplasty and arthrodesis (Girdlestone technique) or chronic suppressive antibiotic therapy; the remaining were, over time, lost to follow-up. Of the patients who concluded the two-stage revision, the ones with high SIRI values (mean 3.08 SD 1.7 and p-value 0.04) and MLR values (mean 0.4 SD 0.2 and p-value 0.02) at the explantation time were associated with a higher probability of infection resolution. Moreover, higher variation in the SIRI and PCR, also defined, respectively, as delta-SIRI (mean -2.3 SD 1.8 and p-value 0.03) and delta-PCR (mean -46 SD 35.7 and p-value 0.03), were associated with favorable outcomes. CONCLUSIONS The results of our study suggest that, in patients with PJI undergoing EP, the SIRI and MLR values and delta-SIRI and delta-PCR values could be predictive of a favorable outcome. The evaluation of these laboratory indices, especially their determination at 4 weeks after removal, could therefore help to determine which patients could be successfully replanted and to identify the best time to replant. More studies analyzing a wider cohort of patients with chronic PJI are needed to validate the promising results of this study.
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Affiliation(s)
- Raffaele Vitiello
- Dipartimento di Ortopedia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (R.V.); (A.Z.); (G.M.)
| | - Alessandro Smimmo
- Department of Orthopedic and Traumatology, Villa Stuart Sport Clinic-FIFA Medical Centre of Excellence, 00135 Rome, Italy;
| | - Elena Matteini
- Dipartimento di Sicurezza e Bioetica—Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giulia Micheli
- Dipartimento di Sicurezza e Bioetica—Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Massimo Fantoni
- Dipartimento di Sicurezza e Bioetica—Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Dipartimento di Scienze di Laboratorio ed Infettivologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
| | - Antonio Ziranu
- Dipartimento di Ortopedia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (R.V.); (A.Z.); (G.M.)
| | - Giulio Maccauro
- Dipartimento di Ortopedia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (R.V.); (A.Z.); (G.M.)
| | - Francesco Taccari
- Dipartimento di Scienze di Laboratorio ed Infettivologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
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Menni AE, Tzikos G, Fyntanidou B, Ioannidis A, Loukipoudi L, Grosomanidis V, Chorti A, Shrewsbury A, Stavrou G, Kotzampassi K. The Effect of Probiotics on the Prognostication of the Neutrophil-to-Lymphocyte Ratio in Severe Multi-Trauma Patients. J Pers Med 2024; 14:419. [PMID: 38673046 PMCID: PMC11051514 DOI: 10.3390/jpm14040419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The ratio of neutrophils to lymphocytes [NLR] is one of the most accepted prognostic indices and demonstrates a positive correlation with the severity of a disease. Given that probiotics exerted immunomodulatory properties and thus positively affected lymphocytopenia induction in severely ill patients, we performed a post hoc analysis in the ProVAP protocol to investigate whether probiotics affected the prognostication of NLR in respect to ventilator-associated pneumonia in multi-trauma patients. This cohort mandatorily involved severe traumatic brain injury patients. METHODS The white blood cell data of all patients, after being retrieved for the days 0 and 7, were statistically assessed in respect to neutrophils, lymphocytes and NLR among the 4 sub-groups of the study: placebo/no-VAP, placebo/VAP, probiotics/no-VAP, and probiotics/VAP. RESULTS Lymphopenia was dominant in placebo sub-groups, while an increased level of lymphocytes was prominent in probiotics sub-groups. This resulted in an increase [p = 0.018] in the NLR value in the probiotics/VAP group in relation to the probiotics/no-VAP cohort; this was an increase of half the value of the placebo/VAP [p < 0.001], while the NLR value in placebo/no-VAP group increased almost four-fold in relation to probiotics/no-VAP [p < 0.001]. Additionally, the ROC curve for probiotic-treated patients revealed a NLR7 cut-off value of 7.20 as a prognostic factor of VAP (AUC: 78.6%, p = 0.015, 95% CI: 62.6-94.5%), having a high specificity of 90.2% and a sensitivity of 42.9%. CONCLUSIONS NLR may considered a credible prognostic biomarker in multi-trauma patients since it can evaluate the immunomodulatory benefits of probiotic treatment. However, the results of the present post hoc analysis should be interpreted meticulously until further evaluation, since they may be basically species- or strain-specific.
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Affiliation(s)
- Alexandra-Eleftheria Menni
- Department of Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece (G.T.); (A.I.); (A.C.); (A.S.)
| | - Georgios Tzikos
- Department of Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece (G.T.); (A.I.); (A.C.); (A.S.)
| | - Barbara Fyntanidou
- Department of Emergency Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Aristeidis Ioannidis
- Department of Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece (G.T.); (A.I.); (A.C.); (A.S.)
| | - Lamprini Loukipoudi
- Department of Anesthesia & Intensive Care, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (L.L.); (V.G.)
| | - Vasilis Grosomanidis
- Department of Anesthesia & Intensive Care, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (L.L.); (V.G.)
| | - Angeliki Chorti
- Department of Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece (G.T.); (A.I.); (A.C.); (A.S.)
| | - Anne Shrewsbury
- Department of Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece (G.T.); (A.I.); (A.C.); (A.S.)
| | - George Stavrou
- Department of General Surgery, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK;
| | - Katerina Kotzampassi
- Department of Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece (G.T.); (A.I.); (A.C.); (A.S.)
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lv D, Zhang K, Zhu C, Xu X, Gong H, Liu L. Predictive value of CD86 for the occurrence of sepsis (Sepsis-3) in patients with infection. PLoS One 2024; 19:e0302063. [PMID: 38603712 PMCID: PMC11008888 DOI: 10.1371/journal.pone.0302063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 03/27/2024] [Indexed: 04/13/2024] Open
Abstract
This prospective observational study explored the predictive value of CD86 in the early diagnosis of sepsis in the emergency department. The primary endpoint was the factors associated with a diagnosis of sepsis. The secondary endpoint was the factors associated with mortality among patients with sepsis. It enrolled inpatients with infection or high clinical suspicion of infection in the emergency department of a tertiary Hospital between September 2019 and June 2021. The patients were divided into the sepsis and non-sepsis groups according to the Sepsis-3 standard. The non-sepsis group included 56 patients, and the sepsis group included 65 patients (19 of whom ultimately died). The multivariable analysis showed that CD86% (odds ratio [OR] = 1.22, 95% confidence interval [CI]: 1.04-1.44, P = 0.015), platelet count (OR = 0.99, 95%CI: 0.986-0.997, P = 0.001), interleukin-10 (OR = 1.01, 95%CI: 1.004-1.025, P = 0.009), and procalcitonin (OR = 1.17, 95%CI: 1.01-1.37, P = 0.043) were independent risk factors for sepsis, while human leukocyte antigen (HLA%) (OR = 0.96, 05%CI: 0.935-0.995, P = 0.022), respiratory rate (OR = 1.16, 95%CI: 1.03-1.30, P = 0.014), and platelet count (OR = 1.01, 95%CI: 1.002-1.016, P = 0.016) were independent risk factors for death in patients with sepsis. The model for sepsis (CD86%, platelets, interleukin-10, and procalcitonin) and the model for death (HLA%, respiratory rate, and platelets) had an area under the curve (AUC) of 0.870 and 0.843, respectively. CD86% in the first 24 h after admission for acute infection was independently associated with the occurrence of sepsis in the emergency department.
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Affiliation(s)
- Dan lv
- Department of Emergency, Renji Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai, China
| | - Keji Zhang
- Department of Emergency, Renji Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai, China
| | - Changqing Zhu
- Department of Emergency, Renji Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai, China
| | - Xinhui Xu
- Department of Emergency, Renji Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai, China
| | - Hao Gong
- Department of Emergency, Renji Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai, China
| | - Li Liu
- Department of Emergency, Renji Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai, China
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Obeagu EI, Obeagu GU. Platelet index ratios in HIV: Emerging biomarkers for immune health and disease management. Medicine (Baltimore) 2024; 103:e37576. [PMID: 38518025 PMCID: PMC10956946 DOI: 10.1097/md.0000000000037576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/21/2024] [Indexed: 03/24/2024] Open
Abstract
Human Immunodeficiency Virus (HIV) infection is a global health challenge that requires continuous advancements in diagnostic and prognostic tools. Traditional markers, such as CD4 cell counts and viral load, have played a crucial role in monitoring disease progression and guiding therapeutic interventions. However, emerging research suggests that platelet index ratios may serve as valuable biomarkers in assessing immune health and managing HIV-associated complications. This paper explores the significance of platelet index ratios, including platelet-to-lymphocyte ratio and mean platelet volume-to-lymphocyte ratio, as potential indicators of immune system status in individuals living with HIV. The interplay between platelets, lymphocytes, and their ratios reflects the dynamic nature of the immune response and inflammatory processes during HIV infection. Understanding the role of platelet index ratios in HIV could lead to the development of accessible and cost-effective biomarkers for monitoring immune health. Implementation of these ratios in routine clinical practice may enhance the precision of disease prognosis and guide personalized treatment strategies. Additionally, the exploration of platelet index ratios may pave the way for innovative therapeutic interventions aimed at modulating immune responses in HIV-infected individuals. In conclusion, platelet index ratios represent promising emerging biomarkers for evaluating immune health and managing HIV-related complications. Further research and clinical validation are warranted to establish the utility of these ratios in routine HIV care, potentially revolutionizing the approach to monitoring and improving the health outcomes of individuals living with HIV.
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Baykara Ulusan M, Meltem E, Mutlu IN, Ulusan K. The predictive value of systemic inflammatory markers in 902 patients with tunneled hemodialysis catheter. J Nephrol 2024:10.1007/s40620-023-01880-w. [PMID: 38512368 DOI: 10.1007/s40620-023-01880-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/26/2023] [Indexed: 03/23/2024]
Abstract
AIM This study aimed to assess the predictive role of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and mean platelet volume, on catheter survival in chronic hemodialysis patients, analyzing both infectious and non-infectious complications. METHODS A retrospective analysis encompassed 1279 tunneled catheter insertion procedures involving 902 patients between March 2014 and October 2018. Patients were categorized into two main groups: (i) initial placement and (ii) exchange. The exchange group was further stratified into four subgroups: infection, dysfunction, displacement, and transitioning temporary hemodialysis catheters to long-term ones. Hematologic ratios were calculated from baseline hemogram data, including neutrophil, lymphocyte, monocyte, and platelet counts, while mean platelet volume was derived from the same hemogram. RESULTS The patients in the exchange group displayed significantly higher lymphocyte and monocyte values (p < 0.001), while lower values were noted for neutrophil-lymphocyte ratio and platelet-lymphocyte ratio (p < 0.001). The transition group displayed higher monocyte values and lower mean platelet volume and lymphocyte-monocyte ratio values (p < 0.05). In the infection-related exchange subgroup, higher neutrophil count, mean platelet volume, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio values were observed compared to other groups (p < 0.05). Cases related to catheter dysfunction exhibited increased lymphocyte-monocyte ratio but lower neutrophil, monocyte, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio values (p < 0.05). CONCLUSION This study highlights the interest of specific inflammatory markers, particularly monocytes, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio, in the management of tunneled catheters, notably in patients undergoing exchanges. However, cut-off values, essential for constructing management algorithms, are currently lacking, and prospective multicenter studies are needed for further elucidation.
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Affiliation(s)
- Melis Baykara Ulusan
- Department of Diagnostic and Interventional Radiology, Istanbul Training and Research Hospital, Samatya, Istanbul, Turkey.
| | - Emine Meltem
- Department of Diagnostic and Interventional Radiology, Istanbul Training and Research Hospital, Samatya, Istanbul, Turkey
| | - Ilhan Nahit Mutlu
- Department of Radiology, Department of Diagnostic and Interventional Radiology, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Kivilcim Ulusan
- Department of General Surgery, Department of Endocrine Surgery, Istanbul Training and Research Hospital, Samatya, Istanbul, Turkey
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Wang X, Li M, Yang Y, Shang X, Wang Y, Li Y. Clinical significance of inflammatory markers for evaluating disease severity of mixed-pathogen bloodstream infections of both Enterococcus spp. and Candida spp. Heliyon 2024; 10:e26873. [PMID: 38434384 PMCID: PMC10907801 DOI: 10.1016/j.heliyon.2024.e26873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 02/17/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
Objective In recent decades, there has been a notable increase in the morbidity and mortality rates linked to bacteremia and candidemia. This study aimed to investigate the clinical significance of inflammatory markers in assessing the disease severity in critically ill patients suffering from mixed-bloodstream infections (BSIs) due to Enterococcus spp. and Candida spp. Methods In this retrospective research, patients diagnosed with BSIs who were admitted to the intensive care unit (ICU) during the period of January 2019 to December 2022 were analyzed. The patients were divided into two groups: a mixed-pathogen BSI group with both Enterococcus spp. and Candida spp., and a single-pathogen BSI group with only Enterococcus spp. The study examined the differences in inflammatory marker levels and disease severity, including Acute Physiology and Chronic Health Evaluation (APACHE) II scores, duration of ICU stay, and 30-day mortality, between the two groups. Furthermore, we sought to scrutinize the potential associations among these aforementioned parameters. Results The neutrophil-to-lymphocyte ratios (NLRs) and levels of plasma C-reactive protein (CRP), interleukin (IL)-6, IL-8, and tumor necrosis factor-α (TNF-α) in the mixed-pathogen BSI group were higher than those in the single-pathogen BSI group. Spearman's rank correlation analysis showed that NLRs and plasma CRP and IL-6 levels were positively correlated with disease severity in the mixed-pathogen BSI group. Further, the levels of plasma IL-8 and TNF-α were also positively correlated with ICU stay duration and 30-day mortality. In multivariate analysis, plasma CRP and IL-6 levels were independently associated with 30-day mortality. Conclusion Mixed-pathogen BSIs caused by Enterococcus spp. and Candida spp. may give rise to increased NLRs and plasma CRP, IL-6, IL-8, and TNF-α levels in comparison to BSI caused by Enterococcus spp. only, thus leading to elevated disease severity in critically ill patients.
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Affiliation(s)
- Xin Wang
- Department of Critical Care Medicine, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100071, China
| | - Ming Li
- Department of Clinical Laboratory, The First Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Yang Yang
- Department of Critical Care Medicine, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100071, China
| | - Xueyi Shang
- Department of Critical Care Medicine, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100071, China
| | - Yonggang Wang
- Department of Critical Care Medicine, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100071, China
| | - Yan Li
- Department of Critical Care Medicine, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100071, China
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Rodriguez IE, Saben JL, Moore EE, Knudson MM, Moore PK, Pieracci F, Sauaia A, Moore HB. Fibrinolysis Resistance After Injury Is a Risk Factor for a Hospital-Acquired Pneumonia-Like Disease Pattern. Surg Infect (Larchmt) 2024; 25:87-94. [PMID: 38394296 PMCID: PMC10924191 DOI: 10.1089/sur.2023.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
Background: Pneumonia is associated with increased morbidity and costs in the intensive care unit (ICU). Its early identification is key for optimal outcomes, but early biomarkers are lacking. Studies suggest that fibrinolysis resistance (FR) after major abdominal surgery is linked to an increased risk of infection. Patients and Methods: Patients in a randomized controlled trial for hemorrhagic shock were evaluated for FR. Fibrinolysis resistance was quantified by thrombelastography with exogenous tissue plasminogen activator (tPA-TEG) at 24- and 48-hours post-injury and measuring LY30 (%). A receiver-operating characteristics (ROC) curve analysis was used to identify a cutoff for increased risk of pneumonia, which was then validated in ICU patients at risk for venous thromboembolism (VTE). Multivariable logistic regression was used to control for confounders. Results: Forty-nine patients in the hemorrhagic shock cohort had tPA-TEGs at 24- and 48-hours (median ISS, 27; 7% pneumonia). A composite tPA-TEG LY30 of less than 4% at 24 and 48 hours was found to be the optimal cutoff for increased risk of pneumonia. This cohort had a seven-fold increased rate of pneumonia (4% vs. 28%; p = 0.048). Eighty-eight patients in the VTE cohort had tPA-TEGs at 24 and 48 hours post-ICU admission (median ISS, 28; 6% pneumonia). The tPA-TEG LY30 of less than 4% was associated with a 10-fold increased rate of pneumonia (19% vs. 1.5%; p = 0.002). In patients with traumatic brain injury, the same association was found (33% vs. 3.2%; p = 0.006). Adjusting for confounders, the tPA-TEG persisted as a substantial risk factor for pneumonia (adjusted odds ratio [OR], 35.7; 95% confidence interval [CI], 1.9-682; p = 0.018). Conclusions: Fibrinolysis resistance quantified by tPA-TEG within 48 hours of ICU admission is associated with an increased risk of pneumonia in patients in hemorrhagic shock and those at risk for VTE. Prospective validation of the tPA-TEG LY30 optimal cutoff for pneumonia and further investigation into whether endogenous FR is a cause of an altered immunity is warranted.
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Affiliation(s)
- Ivan E. Rodriguez
- Colorado Center for Transplantation Care, Research, and Education (CCTCARE), University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jessica L. Saben
- Colorado Center for Transplantation Care, Research, and Education (CCTCARE), University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ernest E. Moore
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Surgery, Ernest E. Shock Trauma Center at Denver Health, Denver, Colorado, USA
| | - M. Margaret Knudson
- Department of Surgery, University of California San Francisco, San Francisco, California, USA
| | - Peter K. Moore
- University of Colorado Denver, Anschutz Medical Campus, School of Medicine, Aurora, Colorado, USA
| | - Fredric Pieracci
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Surgery, Ernest E. Shock Trauma Center at Denver Health, Denver, Colorado, USA
| | - Angela Sauaia
- Department of Surgery, Ernest E. Shock Trauma Center at Denver Health, Denver, Colorado, USA
| | - Hunter B. Moore
- Colorado Center for Transplantation Care, Research, and Education (CCTCARE), University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Transplant Institution at Porter, AdventHealth, Denver, Colorado, USA
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Hassan M, Abdayem C, El Daouk S, Matar BF. Correlation of Hemoglobin Level With New Inflammatory Markers in the Emergency Department: A Retrospective Study Exploring Neutrophil-to-Lymphocyte, Monocyte-to-Lymphocyte, Platelet-to-Lymphocyte, and Mean Platelet Volume-to-Platelet Count Ratios. Cureus 2024; 16:e55401. [PMID: 38562344 PMCID: PMC10984368 DOI: 10.7759/cureus.55401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
Background Anemia of chronic disease is known to be associated with inflammation. However, the relationship between hemoglobin (Hb) levels and potential inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-platelet count ratio (MPV/PC) has not been extensively studied. The primary objective of this retrospective analytical study conducted at Al Zahraa Hospital University Medical Center (ZHUMC), Beirut, was to investigate the correlation between Hb levels and potential inflammatory markers (NLR, MLR, PLR, MPV/PC) in patients visiting the emergency department (ED), across different genders and age groups. The secondary objectives were to compare Hb levels and inflammatory markers values between the referred medical ward group (the hospitalized patients who were admitted to the medical ward), and the non-referred to medical ward group (the patients who were discharged home from the ED), and to evaluate the predictability of inflammatory markers and Hb levels for referral to the medical ward, including the determination of optimal cutoff values for hospital admission to the medical ward. Methods We analyzed the blood parameters of 379 adult patients who presented to the ED with various medical complaints between September 1, 2022, and November 30, 2022 (three months). These patients were included in the study after we checked their eligibility regarding the verification of all our inclusion and exclusion criteria. Results Our findings revealed a significant negative correlation between Hb levels and PLR (r = -0.24) in both genders and across different age groups. The group referred to the medical ward exhibited lower Hb levels and higher NLR, MLR, and PLR values (P < 0.001). NLR/Hb ratio emerged as a predictive factor for admission in genitourinary (R² = 0.158; OR = 5.62) and respiratory groups (R² = 0.206; OR = 5.89), with specific cutoff values of 0.533 (Sensitivity = 57.1% & Specificity = 84.2%) and 0.276 (Sensitivity = 85% & Specificity = 51.1%), respectively. Conclusions Our study demonstrates that hemoglobin level negatively correlates with PLR. NLR, MLR, and PLR stand as important inflammatory markers. Moreover, we present the first study in the literature to show that NLR/Hb ratio can serve as a predictor for referral to the medical ward, particularly in the genitourinary and respiratory patient groups, underscoring its value in risk assessment as a prognostic marker reflecting the need for admission when the case is more serious.
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Affiliation(s)
- Majd Hassan
- Department of Medicine, Faculty of Medical Sciences, Lebanese University, Beirut, LBN
| | - Charbel Abdayem
- Department of Medicine, Faculty of Medical Sciences, Lebanese University, Beirut, LBN
| | - Sarine El Daouk
- Department of Medicine, Faculty of Public Health 1, Lebanese University, Beirut, LBN
| | - Bassam F Matar
- Department of Hematology and Oncology, Lebanese University, Al-Zahraa Hospital University Medical Center, Beirut, LBN
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Obeagu EI, Obeagu GU. Utilization of immunological ratios in HIV: Implications for monitoring and therapeutic strategies. Medicine (Baltimore) 2024; 103:e37354. [PMID: 38428854 PMCID: PMC10906605 DOI: 10.1097/md.0000000000037354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/02/2024] [Indexed: 03/03/2024] Open
Abstract
Human immunodeficiency virus (HIV) infection remains a significant global health concern, necessitating ongoing research and innovation in the quest for improved disease management. Traditional markers for monitoring HIV progression and the effectiveness of antiretroviral therapy have limitations in capturing the intricate immune responses and inflammatory dynamics in people with HIV. In recent years, the concept of inflammation ratios has gained prominence as a valuable tool for assessing and understanding the complex interplay between inflammation, immune function, and HIV. In this abstract, we provide an overview of the emerging field of utilizing inflammation ratios in the context of HIV and its implications for disease monitoring and therapeutic strategies. These ratios, such as the CD4/CD8 ratio, neutrophil-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio, offer a more comprehensive assessment of an individual's immune status and inflammatory state. By exploring the clinical implications of inflammation ratios, including their potential to predict disease complications and guide personalized treatment approaches, this publication sheds light on the potential benefits of incorporating inflammation ratios into routine HIV care. Furthermore, we emphasize the importance of ongoing research in this field to further refine our understanding of the utility and significance of inflammation ratios in improving the lives of people with HIV.
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Tang J, Zhong Z, Nijiati M, Wu C. Systemic inflammation response index as a prognostic factor for patients with sepsis-associated acute kidney injury: a retrospective observational study. J Int Med Res 2024; 52:3000605241235758. [PMID: 38518195 PMCID: PMC10960344 DOI: 10.1177/03000605241235758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/12/2024] [Indexed: 03/24/2024] Open
Abstract
OBJECTIVE To assess the association between the systemic inflammation response index (SIRI) and the prognosis in patients with sepsis-associated acute kidney injury (SA-AKI). METHODS In this observational study, adult patients with SA-AKI were categorized into three groups based on SIRI tertiles. Survival outcomes were compared across the three groups using Kaplan-Meier survival curves. Various Cox proportional hazards regression models were developed to determine the association between the SIRI and mortality in patients with SA-AKI. Subgroup analyses were also performed to explore the association between different SIRI tertiles and all-cause mortality. RESULTS After adjusting for several confounders, the second SIRI tertile (2.5 < SIRI < 7.6) was found to be an independent risk factor for 30-day mortality [hazard ratio (95% confidence interval): 1.19 (1.01-1.40)], 90-day mortality [1.22 (1.06-1.41)], and 365-day mortality [1.24 (1.09-1.40)]. Furthermore, high SIRI values were associated with increased risks of 30-day, 90-day, and 365-day mortality in patients with SA-AKI across all three models. The third tertile showed a significant association with adverse outcomes in most subgroups. CONCLUSIONS The SIRI serves as a comprehensive biomarker for predicting all-cause mortality of critically ill patients with SA-AKI.
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Affiliation(s)
- Jia Tang
- Graduate School of Xinjiang Medical University, Urumqi, China
| | - Zhenguang Zhong
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Muyesai Nijiati
- Xinjiang Emergency Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Changdong Wu
- Xinjiang Emergency Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
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Wen X, Zhang Y, Xu J, Song C, Shang Y, Yuan S, Zhang J. The early predictive roles of NLR and NE% in in-hospital mortality of septic patients. Heliyon 2024; 10:e26563. [PMID: 38434075 PMCID: PMC10906163 DOI: 10.1016/j.heliyon.2024.e26563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
Background This study aimed to retrospectively investigate the early predictive value of inflammation-related parameters in-hospital mortality of septic patients. Methods We retrospectively recruited 606 patients from Wuhan Union Hospital from January 2009 to October 2022. The inflammation-related parameters including neutrophil-to-lymphocyte ratio (NLR), neutrophil percentage (NE%), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) in survivals and non-survivals on day 1, 2, 3 and 7 after hospitalization were collected and analyzed. Results NLR and NE% in non-survivals (n = 185) were significantly higher than those in survivals (n = 421). The area under the receiver operating characteristic curve (AUC) of NLR or NE% was 0.880 or 0.852 on day 1, 0.770 or 0.790 on day 2, 0.784 or 0.777 on day 3, and 0.732 or 0.741 on day 7. The optimal cut-off values of NLR or NE% for predicting in-hospital mortality were 10.769 or 87.70% on day 1, 17.544 or 90.69% on day 2, 14.395 or 85.00% on day 3, and 9.105 or 83.93% on day 7. The day 1, 2 and 3 NLR and NE% were significant predictors of in-hospital mortality in the Cox proportional hazards models. Conclusions NLR ≥10.769 and NE% ≥ 87.70% could be used early biomarkers for predicting in-hospital mortality of septic patients.
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Affiliation(s)
- Xiaoyue Wen
- Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
| | - Yujing Zhang
- Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
| | - Jiaxin Xu
- Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
| | - Chaoying Song
- Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
| | - You Shang
- Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
| | - Shiying Yuan
- Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
| | - Jiancheng Zhang
- Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, PR China
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Jin S, Yin JB, Li W, Zang LL. Effect of neutrophil to lymphocyte ratio on prognosis of elderly patients with severe sepsis combined with diabetes mellitus. BMC Geriatr 2024; 24:211. [PMID: 38424501 PMCID: PMC10905898 DOI: 10.1186/s12877-024-04757-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND To investigate the predictive value of neutrophil-to-lymphocyte ratio (NLR) in the short-term prognosis of elderly patients with severe sepsis combined with diabetes mellitus (DM). METHODS The clinical data of 162 elderly patients with severe sepsis combined with DM from January 2018 to December 2022 were retrospectively collected. These patients were divided into a survival group (n = 104) and a death group (n = 58) according to 90-day prognosis. The number of neutrophils, lymphocytes, and NLR were compared. The optimal cut-off value for NLR to predict 90-day prognosis in elderly patients with severe sepsis combined with DM was determined using Receiver Operator Characteristic (ROC) curves, and the patients were divided into high and low NLR groups depending on the optimal cut-off value. The Kaplan-Meier method was used to plot the survival curves of the high and low NLR groups. Risk factors for the 90-day death in elderly patients with severe sepsis combined with DM were analyzed by a multivariate cox regression model. RESULTS There were no significant differences in gender, age, history of hypertension and hyperlipidemia, intensive care unit (ICU) stay, duration of mechanical ventilation, and oxygenation index between the survival group and death group (p > 0.05). However, acute physiological and chronic health evaluation II (APACHE II) scores, and sepsis-related organ failure assessment (SOFA) scores were significantly lower in the survival group compared with the death group (p < 0.05). In the survival group, neutrophils counts and NLR were much lower than those in the death group, while lymphocytes counts were much higher (p < 0.05). ROC curves showed that the optimal cut-off value for NLR to predict 90-day mortality in elderly patients with severe sepsis combined with DM was 3.482. Patients were divided into high NLR and low NLR groups based on whether NLR was ≥ 3.482. In terms of the log-rank test results, patients in the low NLR group had a significantly higher 90-day survival rate than those in the high NLR group (Logrank χ2 = 8.635, p = 0.003). The multivariate cox regression model showed that the length of ICU stay longer than 15 days and NLR ≥ 3.482 were independent risk factors for 90-day prognosis in elderly patients with severe sepsis combined with DM. CONCLUSION NLR ≥ 3.482 can be used to predict whether poor prognosis occurs in the short term after illness in elderly patients with severe sepsis combined with DM, and has good assessment value.
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Affiliation(s)
- Shan Jin
- Department of Neurology, Shandong Province 960th Hospital of the People's Liberation Army, 250031, Jinan, Shandong, China.
| | - Jun-Bin Yin
- Department of Neurology, Shandong Province 960th Hospital of the People's Liberation Army, 250031, Jinan, Shandong, China
| | - Wei Li
- Department of Neurology, Shandong Province 960th Hospital of the People's Liberation Army, 250031, Jinan, Shandong, China
| | - Li-Li Zang
- Department of Neurology, Shandong Province 960th Hospital of the People's Liberation Army, 250031, Jinan, Shandong, China
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Ceran B, Alyamaç Dizdar E, Beşer E, Karaçağlar NB, Sarı FN. Diagnostic Role of Systemic Inflammatory Indices in Infants with Moderate-to-Severe Hypoxic Ischemic Encephalopathy. Am J Perinatol 2024; 41:248-254. [PMID: 34666380 DOI: 10.1055/a-1673-1616] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND When the newborn brain is exposed to hypoxia, as in hypoxic ischemic encephalopathy (HIE), it causes an inflammatory response. A wide variety of inflammatory markers are therefore used in the diagnosis of HIE. OBJECTIVE We aimed to determine the diagnostic role of systemic inflammatory indices in infants with moderate-to-severe HIE. We have also investigated the effect of hypothermia treatment over those indices. STUDY DESIGN A retrospective cohort study of infants suffering from moderate-to-severe HIE was conducted in a tertiary-level neonatal intensive care unit between September 2019 and March 2021. Systemic inflammatory indices including systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were calculated for infants with HIE and controls at baseline, and after therapeutic hypothermia in those with HIE. RESULTS A total of 103 infants (53 in the HIE group and 50 in the control group) were included in the study. Median gestational ages (GA) were 39 (37-40) and 38 (37-39) weeks, and median birth weights (BW) were 3,165 (2,890-3,440) and 3,045 (2,850-3,460) g in the HIE and control groups, respectively. GA, BW, mode of delivery, and gender of infants were similar between the groups. Infants in the HIE group had significantly higher NLR (p = 0.001), SII (p = 0.001), PIV (p = 0.001), and SIRI (p = 0.004) values when compared with the control group. Those indices decreased significantly after hypothermia treatment in the HIE group. Areas under curve for NLR, PLR, MLR, SII, SIRI, and PIV to predict HIE were found to be 0.808, 0.597, 0.653, 0.763, 0.686, and 0.663, respectively. Cutoff values having a good ability to predict HIE for SII and NLR were 410 and 1.12. Elevated NLR level above 1.12 was found to be an independent predictor for HIE, as revealed by multivariate analyses. No associations were found between systemic inflammatory indices and amplitude-integrated electroencephalography (aEEG) patterns, presence of seizures, and death. CONCLUSION Systemic inflammatory indices may represent reliable and readily available predictors of HIE risk. NLR seems to be an independent factor in diagnosing moderate-to-severe HIE. KEY POINTS · Systemic inflammatory incides are readily calculated from the peripheral blood count.. · NLR is an independent and valuable factor in diagnosing moderate-to-severe hypoxic-ischemic encephalopathy.. · Systemic inflammatory incides might be feasible for diagnosing hypoxic-ischemic encephalopathy..
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Affiliation(s)
- Burak Ceran
- Department of Neonatology, NICU, Ankara City Hospital, University of Health Sciences, Bilkent, Çankaya, Ankara, Turkey
| | - Evrim Alyamaç Dizdar
- Department of Neonatology, NICU, Ankara City Hospital, University of Health Sciences, Bilkent, Çankaya, Ankara, Turkey
| | - Esra Beşer
- Department of Neonatology, NICU, Ankara City Hospital, University of Health Sciences, Bilkent, Çankaya, Ankara, Turkey
| | - Nazmiye Bengü Karaçağlar
- Department of Neonatology, NICU, Ankara City Hospital, University of Health Sciences, Bilkent, Çankaya, Ankara, Turkey
| | - Fatma Nur Sarı
- Department of Neonatology, NICU, Ankara City Hospital, University of Health Sciences, Bilkent, Çankaya, Ankara, Turkey
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Kim M, Kym D, Park J, Yoon J, Cho YS, Hur J, Chun W, Yoon D. Big data insights into the diagnostic values of CBC parameters for sepsis and septic shock in burn patients: a retrospective study. Sci Rep 2024; 14:800. [PMID: 38191787 PMCID: PMC10774327 DOI: 10.1038/s41598-023-50695-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024] Open
Abstract
Sepsis and septic shock are prevalent and life-threatening complications in burn patients. Despite their severity, existing diagnostic methods are limited. This study aims to evaluate the efficacy of Complete Blood Count (CBC) and CBC ratio markers in diagnosing sepsis and septic shock, and in predicting mortality among burn patients. A cohort of 2757 burn patients was examined to ascertain the correlation between various CBC parameters, their ratios, and the incidence of sepsis and related mortality. Key markers analyzed included Red Cell Distribution Width (RDW), Mean Platelet Volume (MPV), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume-to-Platelet Ratio (MPVPR). Our findings indicate that 65.5% of the patients developed sepsis, and 24.3% succumbed to their conditions. The CBC parameters RDW, MPV, NLR, MPVPR, and MPV-to-Lymphocyte Ratio (MPVLR) were significantly associated with sepsis and mortality. These markers showed considerable temporal variation and yielded an Area Under the Curve (AUC) of over 0.65 in an unadjusted Generalized Estimating Equations (GEE) model. This study underscores the potential of RDW, MPV, NLR, MPVPR, and MPVLR as vital prognostic tools for diagnosing sepsis, septic shock, and predicting mortality in burn patients. Although based on a single-center dataset, our results contribute to the enhancement of sepsis management by facilitating earlier, more precise diagnosis and treatment strategies. Further multi-center research is necessary to confirm these findings and broaden their applicability, establishing a solid base for future explorations in this crucial field.
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Affiliation(s)
- Myongjin Kim
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
| | - Dohern Kym
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea.
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea.
| | - Jongsoo Park
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
| | - Jaechul Yoon
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
| | - Yong Suk Cho
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
| | - Jun Hur
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea.
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea.
| | - Wook Chun
- Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
| | - Dogeon Yoon
- Burn Institutes, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-Ro 7-Gil, Youngdeungpo-Gu, 07247, Seoul, South Korea
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Song ZY, Huang JC, Wang DH, Wang QK, Feng JW, Cao QQ, Chen X, Dai ZP, Gao ZY, Jin Y. Limited value of platelet-related markers in diagnosing periprosthetic joint infection. BMC Musculoskelet Disord 2024; 25:24. [PMID: 38166963 PMCID: PMC10759733 DOI: 10.1186/s12891-023-07142-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE To evaluate the diagnostic values of serum platelet count (PC), mean platelet volume ratio (MPV), platelet count to mean platelet volume ratio (PVR), platelet to lymphocyte ratio (PLR), platelet to neutrophil ratio (PNR), PC/Albumin-globulin ratio (PC/AGR), and PC/C-reactive protein (PC/ CRP) in the diagnosis of periprosthetic joint infection (PJI). METHODS The medical records were retrospectively analyzed of the 158 patients who had undergone hip or knee revisions from January 2018 to May 2022. Of them, 79 cases were diagnosed with PJI and 79 with aseptic loosening (AL). PJI was defined using the Musculoskeletal Infection Society criteria. The plasma levels of CRP, the erythrocyte sedimentation rate (ESR), PC, MPV, PVR, PLR, PNR, PC/AGR, and PC/CRP in the 2 groups were recorded and analyzed. In addition, tests were performed according to different joint types. The receiver operating characteristic curve was used to calculate the sensitivity and specificity of each indicator. The diagnostic value for each indicator was calculated according to the area under the curve (AUC). RESULTS The PC, PVR, PLR and PC/AGR levels in the PJI group were significantly higher than those in the AL group, while PC/CRP levels were significantly lower (P < 0.001). The AUC for PC/CRP, and PC/AGR was 0.804 and 0.802, respectively, which were slightly lower than that of CRP (0.826) and ESR (0.846). ROC analysis for PC/CRP, and PC/AGR revealed a cut-off value of 37.80 and 160.63, respectively, which provided a sensitivity of 73.42% and 84.81% and a specificity of 75.95% and 65.82% for PJI. The area under the curve of PLR and PC was 0.738 and 0.702. The area under the curve values for PVR, PNR, and MPV were 0.672, 0.553, and 0.544, respectively. CONCLUSIONS The results of this study suggest that PC, PLR, PC/CRP, and PC/AGR values do not offer significant advantages over ESR or CRP values when employed for the diagnosis of PJI. PVR, PNR, and MPV were not reliable in the diagnosis of PJI.
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Affiliation(s)
- Zhen-Yu Song
- Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Jin-Cheng Huang
- Department of Orthopaedics, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou University People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Dong-Hui Wang
- Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Qing-Kai Wang
- Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Jia-Wei Feng
- Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Qian-Qian Cao
- Department of Orthopaedics, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou University People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Xiao Chen
- Department of Orthopaedics, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou University People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Zhi-Peng Dai
- Department of Orthopaedics, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou University People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Zong-Yan Gao
- Department of Orthopaedics, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou University People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan Province, China
| | - Yi Jin
- Department of Orthopaedics, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou University People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan Province, China.
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González‐Domínguez A, Cristobal‐Verdejo JI, López‐Espinar C, Fontela‐González S, Vázquez S, Justo‐Domínguez J, González‐Caramazana J, Bragado‐Cuesta M, Álvarez‐Punzano A, Herrería‐Bustillo VJ. Retrospective evaluation of hematological ratios in canine parvovirosis: 401 cases. J Vet Intern Med 2024; 38:161-166. [PMID: 38100467 PMCID: PMC10800196 DOI: 10.1111/jvim.16972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The utility of neutrophil-to-lymphocyte ratio (NLR), platelet to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR) as prognostic indicators has not been investigated in canine parvovirosis (CPV). HYPOTHESIS To evaluate whether these hematological ratios obtained at hospital admission in CPV are associated with outcome or duration of hospitalization. ANIMALS Four hundred one client-owned dogs presented with CPV. Methods-Retrospective multicenter cohort study. Medical records were reviewed to identify dogs with CPV. Data regarding signalment, complete blood count at admission, duration of hospitalization and outcome were collected. RESULTS Of the 401 dogs included in the study, 336 (83.8%) survived to discharge. The median (25th and 75th percentiles) PLR in nonsurvivors (336.56 [159.84-635.77]) was significantly higher than in survivors (217.65 [117.67-389.65]) (P = .003). The area under the receiver-operating characteristic curve for nonsurvival was 0.615 (95% CI [0.593-0.691], P = .003). A cut off of 700 showed a 21.5% sensitivity and 90% specificity for nonsurvival. No association was observed between hospitalization duration and either hematological ratios or total WBC counts. The median (25th and 75th percentiles) lymphocyte count was below reference interval in all dogs and was significantly lower in the dogs which died (0.82 × 109 /L [0.5-1.87]) than in survivors (1.27 × 109 /L [0.73-2.22]) (P = .005). The median (25th and 75th percentiles) monocyte count however was lower in survivors (0.38 × 109 /L [0.29-1.59]), than in nonsurvivors (0.73 × 109 /L [0.1-2]) (P = .002). CONCLUSIONS Evaluation of PLR at hospital admission might be a useful marker of disease severity and could have prognostic value in dogs with CPV.
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Affiliation(s)
- Andrea González‐Domínguez
- Veterinary Teaching Hospital of the Catholic University of Valencia—Emergency and critical careValenciaSpain
- Universidad de Leon—Veterinary Teaching Hospital, Emergency and Critical CareLeonCastilla y LeónSpain
| | | | | | | | - Sergio Vázquez
- Servicio de Oncología, IVC Evidensia Aúna Especialidades VeterinariasValenciaSpain
| | | | | | | | - Alicia Álvarez‐Punzano
- Veterinary Teaching Hospital of the Alfonso X El Sabio—Emergency and Critical CareMadridSpain
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23
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Wong BPK, Lam RPK, Ip CYT, Chan HC, Zhao L, Lau MCK, Tsang TC, Tsui MSH, Rainer TH. Applying artificial neural network in predicting sepsis mortality in the emergency department based on clinical features and complete blood count parameters. Sci Rep 2023; 13:21463. [PMID: 38052864 PMCID: PMC10698015 DOI: 10.1038/s41598-023-48797-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/30/2023] [Indexed: 12/07/2023] Open
Abstract
A complete blood count (CBC) is routinely ordered for emergency department (ED) patients with infections. Certain parameters, such as the neutrophil-to-lymphocyte ratio (NLR), might have prognostic value. We aimed to evaluate the prognostic value of the presenting CBC parameters combined with clinical variables in predicting 30-day mortality in adult ED patients with infections using an artificial neural network (ANN). We conducted a retrospective study of ED patients with infections between 17 December 2021 and 16 February 2022. Clinical variables and CBC parameters were collected from patient records, with NLR, monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) calculated. We determined the discriminatory performance using the area under the receiver operating characteristic curve (AUROC) and performed a 70/30 random data split and supervised ANN machine learning. We analyzed 558 patients, of whom 144 (25.8%) had sepsis and 60 (10.8%) died at 30 days. The AUROCs of NLR, MLR, PLR, and their sum were 0.644 (95% CI 0.573-0.716), 0.555 (95% CI 0.482-0.628), 0.606 (95% CI 0.529-0.682), and 0.610 (95% CI 0.534-0.686), respectively. The ANN model based on twelve variables including clinical variables, hemoglobin, red cell distribution width, NLR, and PLR achieved an AUROC of 0.811 in the testing dataset.
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Affiliation(s)
- Beata Pui Kwan Wong
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Rex Pui Kin Lam
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Carrie Yuen Ting Ip
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ho Ching Chan
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Lingyun Zhao
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Michael Chun Kai Lau
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tat Chi Tsang
- Accident and Emergency Department, Queen Mary Hospital, Hospital Authority, Hong Kong Special Administrative Region, China
| | - Matthew Sik Hon Tsui
- Accident and Emergency Department, Queen Mary Hospital, Hospital Authority, Hong Kong Special Administrative Region, China
| | - Timothy Hudson Rainer
- Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Abdo G, Nir U, Rawajdey R, Abu Dahoud W, Massalha J, Hajouj T, Assadi MH, William N. A Novel Score-Based Approach by Using Routine Laboratory Tests for Accurate Diagnosis of Spontaneous Bacterial Peritonitis (SBP) in Cirrhotic Patients. EJIFCC 2023; 34:297-304. [PMID: 38303756 PMCID: PMC10828535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Background Spontaneous Bacterial Peritonitis (SBP) poses a significant risk to cirrhosis patients with ascites, emphasizing the critical need for early detection and intervention. This retrospective observational study spanning a decade aimed to devise predictive models for SBP using routine laboratory tests. Additionally, it aimed to propose a novel scoring system to aid SBP diagnosis. Methods Data analysis encompassed 229 adult cirrhotic patients hospitalized for ascites between 2012 and 2021. Exclusions eliminated cases of secondary ascites unrelated to liver cirrhosis. Patients were categorized into SBP-positive (n=110) and SBP-negative (n=119) groups. Comparative analysis of demographic details and various laboratory indicators (Neutrophil-to-Lymphocyte Ratio (NLR), Mean Platelet Volume (MPV), C-Reactive Protein (CRP), Platelet (PLT), Alanine Transaminase (ALT), Aspartate Amino Transferase (AST), Potassium (K), Sodium (Na), Total Bilirubin (TB) and International Normalized Ratio (INR) was performed between the groups. The study presented effective SBP prediction models for prompt diagnosis and treatment: a multivariate logistic regression model and a simple scoring system. Findings The study advocates early diagnosis and rapid treatment for all cirrhotic patients with ascites, regardless of cirrhosis stage. Furthermore, it recommends initiating SBP treatment for patients scoring 2-3 in the proposed scoring system while excluding SBP findings for those scoring zero. Conclusion Combining age, sex, and specific laboratory tests (MPV, NLR, CRP, TB, and INR) within random forest models and a simple scoring system enables swift and accurate SBP diagnosis.
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Affiliation(s)
- George Abdo
- Department of Laboratory, Tzafon Medical Center (Poria), Tiberias, affiliated with The Azrieli Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel
- The Mina and Everard Goodman Faculty of Life-Sciences, Bar-Ilan University, Ramat-Gan, 52900, Israel
| | - Uri Nir
- The Mina and Everard Goodman Faculty of Life-Sciences, Bar-Ilan University, Ramat-Gan, 52900, Israel
| | - Rasha Rawajdey
- Research Institute, Tzafon Medical Center (Poria), Tiberias, affiliated with The Azrieli Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel
| | - Wadie Abu Dahoud
- Research Institute, Tzafon Medical Center (Poria), Tiberias, affiliated with The Azrieli Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel
| | - Jammal Massalha
- Department of Information Systems and Computing, Tzafon Medical Center (Poria), Tiberias, affiliated with The Azrieli Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel
| | - Taleb Hajouj
- Department of Laboratory, Tzafon Medical Center (Poria), Tiberias, affiliated with The Azrieli Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel
| | - Mohammad H. Assadi
- Department of Laboratory, Tzafon Medical Center (Poria), Tiberias, affiliated with The Azrieli Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel
| | - Nseir William
- Department of Internal Medicine A, Tzafon Medical Center (Poria), Tiberias, affiliated with affiliated with The Azrieli Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel
- Azrieli Faculty of Medicine in the Galilee, Safed, Israel
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Chen SL, Liu XY, Huang JH, Xian LH, Li XS, Wang KR, Li J, Zhang TC, Huang GG, Liu XQ, Zeng HK, Zhou MH, Jiang WQ. The expression of CD86 in CD3 +CD56 + NKT cells is associated with the occurrence and prognosis of sepsis-associated encephalopathy in sepsis patients: a prospective observational cohort study. Immunol Res 2023; 71:929-940. [PMID: 37405561 DOI: 10.1007/s12026-023-09405-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/27/2023] [Indexed: 07/06/2023]
Abstract
The role of CD3+CD56+ natural killer T (NKT) cells and its co-signaling molecules in patients with sepsis-associated encephalopathy (SAE) is unknown. In this prospective observational cohort study, we initially recruited 260 septic patients and eventually analyzed 90 patients, of whom 57 were in the SAE group and 37 were in the non-SAE group. Compared to the non-SAE group, 28-day mortality was significantly increased in the SAE group (33.3% vs. 12.1%, p = 0.026), while the mean fluorescence intensity (MFI) of CD86 in CD3+CD56+ NKT cells was significantly lower (2065.8 (1625.5 ~ 3198.8) vs. 3117.8 (2278.1 ~ 5349), p = 0.007). Multivariate analysis showed that MFI of CD86 in NKT cells, APACHE II score, and serum albumin were independent risk factors for SAE. Furthermore, the Kaplan-Meier survival analysis indicated that the mortality rate was significantly higher in the high-risk group than in the low-risk group (χ2 = 14.779, p < 0.001). This study showed that the decreased expression of CD86 in CD3+CD56+ NKT cells is an independent risk factor of SAE; thus, a prediction model including MFI of CD86 in NKT cells, APACHE II score, and serum albumin can be constructed for diagnosing SAE and predicting prognosis.
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Affiliation(s)
- Sheng-Long Chen
- Department of Emergency&Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China
- Medical College, Shantou University, Shantou, 515041, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, 1063 Shatai Nan Road, Guangzhou, 510515, China
| | - Xiao-Yu Liu
- Department of Emergency&Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China
| | - Jun-Hong Huang
- Department of Emergency&Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China
- School of Medicine, South China University of Technology, Guangzhou, 510006, China
| | - Lu-Hua Xian
- Laboratory Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China
| | - Xu-Sheng Li
- Department of Emergency&Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China
| | - Kang-Rong Wang
- Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Jing Li
- Department of Emergency&Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, 1063 Shatai Nan Road, Guangzhou, 510515, China
| | - Tian-Cao Zhang
- Department of Emergency&Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China
- Medical College, Shantou University, Shantou, 515041, Guangdong, China
| | - Guo-Ge Huang
- Department of Emergency&Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China
| | - Xin-Qiang Liu
- Department of Emergency&Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China
| | - Hong-Ke Zeng
- Department of Emergency&Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China
| | - Mao-Hua Zhou
- Laboratory Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China.
| | - Wen-Qiang Jiang
- Department of Emergency&Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China.
- Medical College, Shantou University, Shantou, 515041, Guangdong, China.
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, Guangdong, China.
- The Second School of Clinical Medicine, Southern Medical University, 1063 Shatai Nan Road, Guangzhou, 510515, China.
- School of Medicine, South China University of Technology, Guangzhou, 510006, China.
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Chen J, Yasrebinia S, Ghaedi A, Khanzadeh M, Quintin S, Dagra A, Peart R, Lucke-Wold B, Khanzadeh S. Meta-analysis of the role of neutrophil to lymphocyte ratio in neonatal sepsis. BMC Infect Dis 2023; 23:837. [PMID: 38012554 PMCID: PMC10683320 DOI: 10.1186/s12879-023-08800-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION The neutrophil to lymphocyte ratio (NLR), an inflammatory biomarker, measures innate-adaptive immune system balance. In this systematic review and meta-analysis, we aim to analyze the current literature to evaluate the diagnostic role of NLR in neonatal sepsis. METHODS PubMed, Web of Science, and Scopus were used to conduct a systematic search for relevant publications published before May 14, 2022. RESULTS Thirty studies, including 2328 neonates with sepsis and 1800 neonates in the control group, were included in our meta-analysis. The results indicated that NLR is higher in neonates with sepsis compared to healthy controls (SMD = 1.81, 95% CI = 1.14-2.48, P-value < 0.001) in either prospective (SMD = 2.38, 95% CI = 1.40-3.35, P-value < 0.001) or retrospective studies (SMD = 0.87, 95% CI = 0.63-1.12, P-value < 0.001) with a pooled sensitivity of 79% (95% CI = 62-90%), and a pooled specificity of 91% (95% CI = 73-97%). Also, we found that NLR is higher in neonates with sepsis compared to those who were suspected of sepsis but eventually had negative blood cultures (SMD =1.99, 95% CI = 0.76-3.22, P-value = 0.002) with a pooled sensitivity of 0.79% (95% CI = 0.69-0.86%), and a pooled specificity of 73% (95% CI = 54-85%). In addition, neonates with sepsis had elevated levels of NLR compared to other ICU admitted neonates (SMD = 0.73, 95% CI = 0.63-0.84, P < 0.001). The pooled sensitivity was 0.65 (95% CI, 0.55-0.80), and the pooled specificity was 0.80 (95% CI, 0.68-0.88). CONCLUSION Our findings support NLR as a promising biomarker that can be readily integrated into clinical settings to aid in diagnosing neonatal sepsis. As evidenced by our results, restoring balance to the innate and adaptive immune system may serve as attractive therapeutic targets. Theoretically, a reduction in NLR values could be used to measure therapeutic efficacy, reflecting the restoration of balance within these systems.
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Affiliation(s)
- Jingyang Chen
- The First Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, China
| | | | - Arshin Ghaedi
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Monireh Khanzadeh
- Geriatric & Gerontology Department, Medical School, Tehran University of Medical and Health Sciences, Tehran, Iran
| | - Stephan Quintin
- Department of Neurosurgery, University of Florida, Gainesville, FL, 32610, USA
| | - Abeer Dagra
- Department of Neurosurgery, University of Florida, Gainesville, FL, 32610, USA
| | - Rodeania Peart
- Department of Neurosurgery, University of Florida, Gainesville, FL, 32610, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, FL, 32610, USA
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Rau CS, Kuo SCH, Tsai CH, Chou SE, Su WT, Hsu SY, Hsieh CH. Elevation of White Blood Cell Subtypes in Adult Trauma Patients with Stress-Induced Hyperglycemia. Diagnostics (Basel) 2023; 13:3451. [PMID: 37998587 PMCID: PMC10670758 DOI: 10.3390/diagnostics13223451] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Blood immune cell subset alterations following trauma can indicate a patient's immune-inflammatory status. This research explored the influence of stress-induced hyperglycemia (SIH) on platelet counts and white blood cell (WBC) subtypes, including the derived indices of the monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), in trauma patients. METHODS We studied 15,480 adult trauma patients admitted from 1 January 1998 to 31 December 2022. They were categorized into four groups: nondiabetic normoglycemia (NDN, n = 11,602), diabetic normoglycemia (DN, n = 1750), SIH (n = 716), and diabetic hyperglycemia (DH, n = 1412). A propensity score-matched cohort was formed after adjusting for age, sex, and comorbidities, allowing for comparing the WBC subtypes and platelet counts. RESULTS Patients with SIH exhibited significantly increased counts of monocytes, neutrophils, and lymphocytes in contrast to NDN patients. However, no significant rise in platelet counts was noted in the SIH group. There were no observed increases in these cell counts in either the DN or DH groups. CONCLUSIONS Our results demonstrated that trauma patients with SIH showed significantly higher counts of monocytes, neutrophils, and lymphocytes when compared to NDN patients, whereas the DN and DH groups remained unaffected. This underscores the profound association between SIH and elevated levels of specific WBC subtypes.
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Affiliation(s)
- Cheng-Shyuan Rau
- Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung City 83301, Taiwan;
| | - Spencer Chia-Hao Kuo
- Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung City 83301, Taiwan;
| | - Ching-Hua Tsai
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung City 83301, Taiwan; (C.-H.T.); (S.-E.C.); (W.-T.S.); (S.-Y.H.)
| | - Sheng-En Chou
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung City 83301, Taiwan; (C.-H.T.); (S.-E.C.); (W.-T.S.); (S.-Y.H.)
| | - Wei-Ti Su
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung City 83301, Taiwan; (C.-H.T.); (S.-E.C.); (W.-T.S.); (S.-Y.H.)
| | - Shiun-Yuan Hsu
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung City 83301, Taiwan; (C.-H.T.); (S.-E.C.); (W.-T.S.); (S.-Y.H.)
| | - Ching-Hua Hsieh
- Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung City 83301, Taiwan;
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Wang X, Zheng Z, Wang J, Ma H, Wang G, Zhao X. Can Platelets/Mean Platelet Volume Accurately Diagnose Periprosthetic Joint Infection? Revealing Their Actual Diagnostic Efficacy. Infect Drug Resist 2023; 16:7155-7163. [PMID: 38023398 PMCID: PMC10640817 DOI: 10.2147/idr.s420323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Background Currently, there is no single test indicator for diagnosing periprosthetic joint infection (PJI) with an acceptable level of sensitivity. Therefore, ratio indicators have been introduced to improve the accuracy of diagnostic algorithms. Platelet count /mean platelet volume (PMR) is reported to be a potential PJI diagnostic biomarker, but its clinical value for diagnosing PJI is still uncertain. This study aims to provide additional evidence to support the effectiveness of PMR in accurately diagnosing PJI. Methods This study recruited 116 patients with PJI and 137 patients with aseptic loosening, divided them into PJI group and AL group. Collect subjects' preoperative laboratory indicators such as ESR, CRP, PLT, MPV, etc. The area under the curve (AUC) was calculated by plotting the receiver operating characteristic (ROC) curve to determine the diagnostic efficacy of PMR. Results ESR, CRP, PLT, and PLT/MPV were significantly increased in the PJI group, while MPV levels were decreased (both P< 0.001). The AUC of the PMR was 0.752, and the optimal cut-off value for diagnosing chronic PJI was determined to be 27.8 based on the Youden index. The sensitivity and specificity for diagnosing PJI were 79.3% and 47.9%, respectively, with a positive predictive value of 68.27%, a negative predictive value of 69.80%, and a diagnostic odds ratio of 4.97. The AUC (0.752) of the ratio biomarker was lower than that of ESR (0.825) and CRP (0.900). After predictive model calculation, the combination of PMR, CRP, and ESR had an AUC value of 0.910, with a sensitivity of 84.5% and a specificity of 84.7%, showing good discriminative ability. Conclusion Compared with traditional biomarkers ESR and CRP, the value of the PMR for diagnosing PJI is not significant, but it can be used as an auxiliary indicator for PJI diagnosis in combination with other indicators (P<0.001).
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Affiliation(s)
- Xinjie Wang
- Department of Clinic Medicine, Jining Medical University, Jining, Shandong, 272067, People’s Republic of China
| | - Zhongren Zheng
- Department of Clinic Medicine, Jining Medical University, Jining, Shandong, 272067, People’s Republic of China
| | - Jialiang Wang
- Department of Clinic Medicine, Jining Medical University, Jining, Shandong, 272067, People’s Republic of China
| | - Hui Ma
- Department of Joint and Sports Medicine, Affiliated Hospital of Jining Medical University, Jining, Shandong, 272029, People’s Republic of China
| | - Guodong Wang
- Department of Joint and Sports Medicine, Affiliated Hospital of Jining Medical University, Jining, Shandong, 272029, People’s Republic of China
| | - Xiaowei Zhao
- Department of Joint and Sports Medicine, Affiliated Hospital of Jining Medical University, Jining, Shandong, 272029, People’s Republic of China
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Yamaguchi A, Wada K, Moriuchi R, Tao K, Konishi H, Tamaru Y, Kusunoki R, Kuwai T, Kouno H, Kohno H. Proportion of Neutrophils in White Blood Cells as a Useful Marker for Predicting Bacteremic Acute Cholangitis. Intern Med 2023; 62:2795-2802. [PMID: 36792196 PMCID: PMC10602826 DOI: 10.2169/internalmedicine.0945-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/04/2023] [Indexed: 02/16/2023] Open
Abstract
Objective A positive hemoculture in acute cholangitis is serious, but a blood culture result cannot be obtained at the initial diagnosis and so cannot be used for the severity assessment and decision-making concerning urgent/early biliary drainage. Accordingly, a predictor for bacteremia at the initial diagnosis of acute cholangitis would be particularly useful. We investigated the association between neutrophil proportions in white blood cell counts (%Neutro) and bacteremic acute cholangitis. Methods Of 166 patients with acute cholangitis who were diagnosed with the Tokyo Guidelines 2018/2013 from April 2015 to March 2017, a total of 94 underwent blood culture assessments and were divided into those with a positive hemoculture (n=48) and a negative hemoculture (n=46) and then compared. A receiver operating characteristic curve analysis was used to evaluate the predictive ability of %Neutro and other inflammatory markers. Results The %Neutro values were significantly higher in the positive hemoculture group than in the negative hemoculture group (91.7±4.0% vs. 82.5±9.0%, p<0.0001). A cut-off %Neutro value of 89.7% was strongly associated with bacteremia (area under the curve 0.86, sensitivity 77.1%, specificity 80.4%). A %Neutro of ≥89.7% was a predictor of a positive hemoculture in univariate (p<0.0001) and multivariate analyses (p<0.001). Patients with a %Neutro ≥89.7% needed early biliary drainage more frequently than others (30/46, 65.2% vs. 18/48, 37.5%, p=0.0063). Conclusion %Neutro is an independent predictor of bacteremia in patients with acute cholangitis and may contribute to decision-making concerning early biliary drainage.
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Affiliation(s)
- Atsushi Yamaguchi
- Department of Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Japan
| | - Kaoru Wada
- Department of Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Japan
| | - Riho Moriuchi
- Department of Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Japan
| | - Kanae Tao
- Department of Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Japan
| | - Hirona Konishi
- Department of Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Japan
| | - Yuzuru Tamaru
- Department of Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Japan
| | - Ryusaku Kusunoki
- Department of Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Japan
| | - Toshio Kuwai
- Department of Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Japan
| | - Hirotaka Kouno
- Department of Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Japan
| | - Hiroshi Kohno
- Department of Gastroenterology, Kure Medical Center and Chugoku Cancer Center, Japan
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Talmac MA, Ciftpinar T, Ozdemir MS, Yardimci AH, Gunay I, Kocadal NC. Can the Combination of Magnetic Resonance Imaging, Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Predict the Mass Origin in Ovarian Masses? SISLI ETFAL HASTANESI TIP BULTENI 2023; 57:326-331. [PMID: 37900344 PMCID: PMC10600603 DOI: 10.14744/semb.2023.47529] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 08/20/2023] [Accepted: 08/31/2023] [Indexed: 10/31/2023]
Abstract
Objective Evaluate the effectiveness of magnetic resonance imaging (MRI), blood parameters, and tumor markers to determine the role of objective criteria in distinguishing malignant, borderline, and benign masses and to minimize unnecessary surgical interventions by reducing interpretation differences. Methods The histopathological and clinical-laboratory results of the patients who underwent surgery for the initial diagnosis and whose ovarian masses were confirmed were retrospectively reviewed. Between groups, age, cancer antigen 125, mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), the presence of ascites, the ovarian-adnexal reporting and data system MRI scores, mass characteristics, and lymphocyte count were compared. Results The study comprised a total of 191 patients. These patients were categorized into three groups: Benign (n=113), borderline (n=26), and malignant (n=52). No noteworthy correlation was detected between the unilocular or multilocular nature of solid, cystic, or mixed masses and the rates of NLR, PLR, or MPV. However, a notable correlation was identified between NLR and the presence of acidity (p=0.003). In ovarian cancer patients, there was no significant difference in NLR and MPV between malignant epithelial and malignant sex cord-stromal types (p>0.05), whereas a significant difference emerged in the PLR ratio (p=0.013). Conclusion In ovarian masses with malignant potential, laboratory parameters such as NLR and PLR can guide the diagnosis process. In the future, various studies such as the development of different tests, markers, and imaging methods, the use of blood tests such as NLR, PLR, and MPV in cancer diagnosis will be possible. The results of these studies may contribute to the development of new methods for the diagnosis of ovarian cancer and the improvement of treatment protocols.
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Affiliation(s)
- Merve Aldikactioglu Talmac
- Department of Gynecological Oncology, University of Health Sciences Türkiye, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye
| | - Tolga Ciftpinar
- Department of Gynecological Oncology, University of Health Sciences Türkiye, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye
| | - Merve Sam Ozdemir
- Department of Radiology, University of Health Sciences Türkiye, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye
| | - Aytul Hande Yardimci
- Department of Radiology, University of Health Sciences Türkiye, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye
| | - Izel Gunay
- Department of Obstetrics and Gynecology, University of Health Sciences Türkiye, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye
| | - Nilufer Cetinkaya Kocadal
- Department of Gynecological Oncology, University of Health Sciences Türkiye, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye
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Domnicu AE, Boia ER, Mogoi M, Manea AM, Marcovici TM, Mărginean O, Boia M. The Neutrophil-to-Lymphocyte Ratio (NLR) Can Predict Sepsis's Presence and Severity in Malnourished Infants-A Single Center Experience. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1616. [PMID: 37892278 PMCID: PMC10605152 DOI: 10.3390/children10101616] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023]
Abstract
Sepsis represents one of the leading causes of death in newborns and infants, and prompt diagnosis is essential for achieving favorable outcomes. Regarding malnourished children with concurrent infection, most studies have focused, besides blood culture, on C-reactive protein and procalcitonin. Because malnutrition has a deleterious effect on cellular immune competence, the present study characterized the acute-phase response, including hematological indices, in response to sepsis. Among the examined laboratory biomarkers, procalcitonin and neutrophil-to-lymphocyte ratio were the most accurate discriminators between sepsis patients and those with bacterial infection. Moreover, these two parameters showed a gradual increase between sepsis, severe sepsis, and septic shock patients (p < 0.001). Subgroup analysis of the sepsis group revealed positive correlations of NLR with prolonged ICU stay (<0.001), acute organ dysfunction (0.038), mechanical ventilation (<0.001), and fatality (<0.001). In summary, our results suggest that the neutrophil-to-lymphocyte ratio can be used as an auxiliary diagnostic index in discriminating the presence and severity of bacterial sepsis in malnourished infants.
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Affiliation(s)
- Alina Emilia Domnicu
- Ph.D. School Department, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
- Clinical Section I Pediatrics—Nutritional Recovery, Children’s Emergency Hospital ‘Louis Turcanu’, 300011 Timisoara, Romania;
| | - Eugen Radu Boia
- Department IX Surgery I, Discipline ENT, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
- ENT Department, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Mirela Mogoi
- Pediatric Department, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
| | - Aniko-Maria Manea
- Neonatology and Puericulture Department, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania; (A.-M.M.); (M.B.)
- Neonatology and Preterm Department, Children’s Emergency Hospital ‘Louis Turcanu’, 300011 Timisoara, Romania
| | - Tamara Marcela Marcovici
- Clinical Section I Pediatrics—Nutritional Recovery, Children’s Emergency Hospital ‘Louis Turcanu’, 300011 Timisoara, Romania;
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
| | - Otilia Mărginean
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
- Department of Pediatrics I, Children’s Emergency Hospital ‘Louis Turcanu’, 300011 Timisoara, Romania
- Department XI Pediatrics, Discipline I Pediatrics, Disturbances of Growth and Development in Children—BELIVE, 300011 Timisoara, Romania
| | - Marioara Boia
- Neonatology and Puericulture Department, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania; (A.-M.M.); (M.B.)
- Neonatology and Preterm Department, Children’s Emergency Hospital ‘Louis Turcanu’, 300011 Timisoara, Romania
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Johnson MM, Gicking JC, Keys DA. Evaluation of red blood cell distribution width, neutrophil-to-lymphocyte ratio, and other hematologic parameters in canine acute pancreatitis. J Vet Emerg Crit Care (San Antonio) 2023; 33:587-597. [PMID: 37573255 DOI: 10.1111/vec.13325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 08/14/2023]
Abstract
OBJECTIVE To determine if RBC distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and other hematological parameters are associated with increased odds of in-hospital mortality, increased length of hospitalization (LOH), or disease severity as measured by the Canine Acute Pancreatitis Severity (CAPS) score in dogs with acute pancreatitis (AP). DESIGN Retrospective, multicenter study from January 2016 to August 2020. SETTING Four private emergency and specialty referral centers. ANIMALS On initial case search, 118 client-owned dogs were identified with a clinical diagnosis of AP. Out of these cases, 114 dogs met inclusion criteria, defined as sudden onset of ≥2 compatible clinic signs (lethargy, anorexia, vomiting, or abdominal pain), a specific canine pancreatic lipase concentration >400 μg/L, hospital admission, as well as CBC and serum biochemistry run within 48 hours of initial hospitalization. Disease severity was calculated and measured using the CAPS score, in addition to LOH and in-hospital mortality. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Clinical endpoints were in-hospital mortality, LOH, and disease severity, as evaluated by the CAPS score. Overall in-hospital mortality was 36.8%. NLR was significantly associated with survival, with a higher percentage being associated with an increased likelihood of nonsurvival (odds ratio: 1.1, 95% confidence interval: 1.0-1.2; P = 0.006, adjusted P = 0.04). Increased NLR was found to be significantly associated with a longer LOH based on the unadjusted P-value (P = 0.02) but was not statistically significant based on a P-value adjusted for multiple comparisons (P = 0.12). No significant associations were noted when RDW, platelet-to-lymphocyte ratio, WBC count, mean platelet volume, RDW-to-platelet ratio, or RDW-to-total serum calcium ratio was evaluated against outcome measures. CONCLUSIONS This study retrospectively evaluated the prognostic utility of several readily available hematological parameters in dogs hospitalized for AP. Dogs with an increased NLR may have a higher risk of in-hospital mortality and increased LOH, although future prospective studies are necessary to confirm these findings.
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Affiliation(s)
- Meghan M Johnson
- Emergency & Critical Care Service, BluePearl Specialty + Emergency Pet Hospital, Lafayette, Colorado, USA
| | - John C Gicking
- Emergency & Critical Care Service, BluePearl Specialty + Emergency Pet Hospital, Tampa, Florida, USA
| | - Deborah A Keys
- Kaleidoscope Statistics Veterinary Medical Research Consulting, Athens, Georgia, USA
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Bilgin M, Aci R, Keskin A, Yilmaz EM, Polat E. Evaluation of the relationship between procalcitonin level and the causative pathogen in intensive care patients with sepsis. Future Microbiol 2023; 18:875-883. [PMID: 37594461 DOI: 10.2217/fmb-2023-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
Aim: This study was designed to investigate how procalcitonin (PCT) levels are affected by different pathogens in patients with sepsis. Materials & methods: A total of 110 Gram-positive sepsis, 62 Gram-negative sepsis and 27 fungal sepsis patients were included in the study. Kaplan-Meier and ROC curve analysis was performed to assess PCT levels. Results: PCT levels were 2.36 ng/ml in Gram-negative patients, 0.79 ng/ml in Gram-positive patients and 0.89 ng/ml in fungal patients. The area under the curve for PCT was 0.608, the cutoff value was 1.34, sensitivity was 56.50% the specificity was 56.50%. Conclusion: PCT survival levels of 7.71 ng/ml in Gram-negative patients, 2.65 ng/ml in Gram-positive patients and 1.16 ng/ml in fungal patients can be evaluated to predict survival.
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Affiliation(s)
- Melek Bilgin
- Department of Microbiology, Samsun Training & Research Hospital, Ilkadim, Samsun, 55090, Turkey
| | - Recai Aci
- Department of Biochemistry, Samsun Training & Research Hospital, Ilkadim, Samsun, 55090, Turkey
| | - Adem Keskin
- Department of Medicinal Biochemistry, Institute of Health Sciences, Aydin Adnan Menderes University, Efeler, Aydın, 09100, Turkey
| | - Esmeray M Yilmaz
- Department of Clinical Microbiology & Infectious Diseases, Samsun Training & Research Hospital, Ilkadim, Samsun, 55090, Turkey
| | - Ebru Polat
- Department of Anesthesiology & Reanimation, Samsun Training & Research Hospital, Ilkadim, Samsun, 55090, Turkey
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Bai L, Gong P, Jia X, Zhang X, Li X, Zhang Y, Zhou H, Kang Y. Comparison of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for the diagnosis of neonatal sepsis: a systematic review and meta-analysis. BMC Pediatr 2023; 23:334. [PMID: 37391699 PMCID: PMC10311819 DOI: 10.1186/s12887-023-04094-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/25/2023] [Indexed: 07/02/2023] Open
Abstract
PURPOSE To compare the performance of Neutrophil-to-Lymphocyte Ratio (NLR) with that of Platelet-to-Lymphocyte Ratio (PLR) in diagnosing neonatal sepsis (NS). METHODS PubMed and Embase were searched for relevant studies from the inception of the databases to May, 2022. The pooled sensitivity (SEN), specificity (SPE), and area under the receiver operator characteristic curve (AUC) were measured. RESULTS Thirteen studies involving 2610 participants were included. The SEN, SPE, and AUC of NLR were 0.76 (95%CI: 0.61-0.87), 0.82 (95%CI: 0.68-0.91), and 0.86 (95%CI: 0.83-0.89), respectively, and those of PLR were 0.82 (95%CI: 0.63-0.92), 0.80 (95%CI: 0.24-0.98), and 0.87 (95%CI: 0.83-0.89), respectively. Significant heterogeneity was observed among the studies. Subgroup analysis and meta-regression showed that types of sepsis (p = 0.01 for SEN), gold standard (p = 0.03 for SPE), and pre-set threshold (p<0.05 for SPE) might be the sources of heterogeneity for NLR, whereas the pre-set threshold (p<0.05 for SPE) might be the source of heterogeneity for PLR. CONCLUSIONS NLR and PLR would be of great accuracy for the diagnosis of NS, and the two indicators have similar diagnostic performance. However, the overall risk of bias was high, and significant heterogeneity was identified among the included studies. The results of this study should be interpreted prudently, and the normal or cut-off values and the type of sepsis should be considered. More prospective studies are needed to further support the clinical application of these findings.
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Affiliation(s)
- Lixia Bai
- Department of Shanxi Children's Hospital (Shanxi Maternal and Child Health Hospital), Medical Services Section, Taiyuan, China.
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China.
| | - Peihui Gong
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xiaoyun Jia
- Department of Cadre Health Care Management, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Xinhua Zhang
- Department of Shanxi Children's Hospital (Shanxi Maternal and Child Health Hospital), Neonatal Pediatrics, Taiyuan, China
| | - Xiuhui Li
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yueqin Zhang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Hao Zhou
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yanan Kang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
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Oliveira AJMD, Rabelo NN, Telles JPM, Solla DJF, Coelho ACSDS, Barbosa GB, Barbato NC, Yoshikawa MH, Teixeira MJ, Figueiredo EG. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios and prognosis after aneurysmal subarachnoid hemorrhage: a cohort study. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:515-523. [PMID: 37379863 DOI: 10.1055/s-0043-1768662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
BACKGROUND Subarachnoid hemorrhage (SAH) prognosis remains poor. Vasospasm mechanism might be associated with inflammation. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been studied as inflammation markers and prognostic predictors. OBJECTIVE We aimed to investigate NLR and PLR in admission as predictors of angiographic vasospasm and functional outcome at 6 months. METHODS This cohort study included consecutive aneurysmal SAH patients admitted to a tertiary center. Complete blood count was recorded at admission before treatment. White blood cell count, neutrophil count, lymphocyte count, platelet count, NLR, and PLR were collected as independent variables. Vasospasm occurrence-modified Rankin scale (mRS), Glasgow outcome scale (GOS), and Hunt-Hess score at admission and at 6 months were recorded as dependent variables. Multivariable logistic regression models were used to adjust for potential confounding and to assess the independent prognostic value of NLR and PLR at admission. RESULTS A total of 74.1% of the patients were female, with mean age of 55.6 ± 12.4 years. At admission, the median Hunt-Hess score was 2 (interquartile range [IQR] 1), and the median mFisher was 3 (IQR 1). Microsurgical clipping was the treatment for 66.2% of the patients. Angiographic vasospasm incidence was 16.5%. At 6 months, the median GOS was 4 (IQR 0.75), and the median mRS was 3 (IQR 1.5). Twenty-one patients (15.1%) died. Neutrophil-to-lymphocyte ratio and PLR levels did not differ between favorable and unfavorable (mRS > 2 or GOS < 4) functional outcomes. No variables were significantly associated with angiographic vasospasm. CONCLUSION Admission NLR and PLR presented no value for prediction of functional outcome or angiographic vasospasm risk. Further research is needed in this field.
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Affiliation(s)
- Adilson Jose Manuel de Oliveira
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Neurocirurgia, São Paulo SP, Brazil
- Clínica Girassol, Divisão de Neurocirurgia, Luanda, Angola
| | - Nicollas Nunes Rabelo
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Neurocirurgia, São Paulo SP, Brazil
| | - João Paulo Mota Telles
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Neurocirurgia, São Paulo SP, Brazil
| | - Davi Jorge Fontoura Solla
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Neurologia, São Paulo SP, Brazil
| | | | | | | | - Marcia Harumy Yoshikawa
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, São Paulo SP, Brazil
| | - Manoel Jacobsen Teixeira
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Neurocirurgia, São Paulo SP, Brazil
| | - Eberval Gadelha Figueiredo
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Neurocirurgia, São Paulo SP, Brazil
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Zanon IDB, Meves R, Klautau GB. The Relative Lymphocyte Count is Lower when the Etiological Agent in Pott Disease is Successfully Isolated
*. Rev Bras Ortop 2023; 58:92-100. [PMID: 36969768 PMCID: PMC10038726 DOI: 10.1055/s-0042-1756638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 07/18/2022] [Indexed: 03/26/2023] Open
Abstract
Objective
To describe the clinico-epidemiological, laboratory, and radiological characteristics of tuberculous spondylodiscitis in the Brazilian population, and to assess whether there are differences between patients in whom the etiological agent in Pott disease was isolated or not.
Methods
Patients diagnosed with tuberculosis (TB) of the spine (Pott disease) underwent follow-up between 2009 and 2019 at a quaternary hospital and were divided into 2 groups: successful isolation (SI) of the etiological agent (through bacilloscopy, culture, or positive molecular rapid test) and unsuccessful isolation (UI) of the etiological agent.
Results
From a total of 26 patients diagnosed with TB of the spine, 21 (80.7%) were male, with a mean age of 40 ± 22.5 years. The average lymphocyte counts were higher in the UI group (25.35 ± 13.08;
p
= 0.025) compared to the SI group (14.18 ± 7.48). Moreover, the monocyte/lymphocyte ratio was lower in the UI group (0.39 ± 0.22;
p
= 0.009) than in the SI group (0.89 ± 0.65). Relative lymphocyte counts higher than or equal to 16.7 had a sensitivity of 76.9% and specificity of 62.5% in the UI group. Values higher than or equal to 0.58 for the monocyte/lymphocyte ratio showed a sensitivity of 84.6% and specificity of 75.0% in the UI group.
Conclusion
No differences were observed regarding the clinico-epidemiological and radiological characteristics of the two experimental groups. However, the UI group had higher lymphocyte counts and a lower monocyte/lymphocyte ratio.
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Affiliation(s)
- Igor de Barcellos Zanon
- Grupo de Afecções da Coluna Vertebral, Departamento de Ortopedia e Traumatologia, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
- Endereço para correspondência Igor de Barcellos Zanon, MD, MSc Rua Doutor Cesário Motta Júnior112, Vila Buarque, São Paulo, SPBrasil
| | - Robert Meves
- Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
| | - Giselle Burlamaqui Klautau
- Grupo de Afecções da Coluna Vertebral, Departamento de Ortopedia e Traumatologia, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
- Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
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Nguyen A, Nguyen A, Hsu TI, Lew HD, Gupta N, Nguyen B, Mandavalli A, Diaz MJ, Lucke-Wold B. Neutrophil to Lymphocyte Ratio as a Predictor of Postoperative Outcomes in Traumatic Brain Injury: A Systematic Review and Meta-Analysis. Diseases 2023; 11:diseases11010051. [PMID: 36975600 PMCID: PMC10047119 DOI: 10.3390/diseases11010051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/05/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Abstract
(1) Introduction: Traumatic brain injury (TBI) is a leading cause of injury and mortality worldwide, carrying an estimated cost of $38 billion in the United States alone. Neutrophil to lymphocyte ratio (NLR) has been investigated as a standardized biomarker that can be used to predict outcomes of TBI. The aim of this review was to determine the prognostic utility of NLR among patients admitted for TBI. (2) Methods: A literature search was conducted in PubMed, Scopus, and Web of Science in November 2022 to retrieve articles regarding the use of neutrophil to lymphocyte ratio (NLR) as a prognostic measure in traumatic brain injury (TBI) patients. Inclusion criteria included studies reporting outcomes of TBI patients with associated NLR values. Exclusion criteria were studies reporting only non-primary data, those insufficiently disaggregated to extract NLR data, and non-English or cadaveric studies. The Newcastle-Ottawa Scale was utilized to assess for the presence of bias in included studies. (3) Results: Following the final study selection 19 articles were included for quantitative and qualitative analysis. The average age was 46.25 years. Of the 7750 patients, 73% were male. Average GCS at presentation was 10.51. There was no significant difference in the NLR between surgical vs. non-surgical cohorts (SMD 2.41 95% CI −1.82 to 6.63, p = 0.264). There was no significant difference in the NLR between bleeding vs. non-bleeding cohorts (SMD 4.84 95% CI −0.26 to 9.93, p = 0.0627). There was a significant increase in the NLR between favorable vs. non-favorable cohorts (SMD 1.31 95% CI 0.33 to 2.29, p = 0.0090). (4) Conclusions: Our study found that NLR was only significantly predictive for adverse outcomes in TBI patients and not surgical treatment or intracranial hemorrhage, making it nonetheless an affordable alternative for physicians to assess patient prognosis.
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Affiliation(s)
- Andrew Nguyen
- College of Medicine, University of Florida, Gainesville, FL 32601, USA
| | - Alexander Nguyen
- College of Medicine, University of Florida, Gainesville, FL 32601, USA
| | - Timothy I. Hsu
- School of Medicine, University of California, Irvine, CA 92617, USA
| | - Harrison D. Lew
- College of Medicine, University of Florida, Gainesville, FL 32601, USA
| | - Nithin Gupta
- School of Medicine, Campbell University, Lillington, NC 27546, USA
| | - Brandon Nguyen
- Alix School of Medicine, Mayo Clinic, Scottsdale, AZ 85054, USA
| | - Akhil Mandavalli
- College of Medicine, University of Florida, Gainesville, FL 32601, USA
| | - Michael J. Diaz
- College of Medicine, University of Florida, Gainesville, FL 32601, USA
- Correspondence:
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
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Hua Y, Sun JY, Lou YX, Sun W, Kong XQ. Monocyte-to-lymphocyte ratio predicts mortality and cardiovascular mortality in the general population. Int J Cardiol 2023; 379:118-126. [PMID: 36905945 DOI: 10.1016/j.ijcard.2023.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/03/2023] [Accepted: 03/05/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND Systemic chronic inflammation (SCI) is closely involved in the pathogenesis of many diseases. This study aims to investigate the association between MLR with mortality and cardiovascular disease (CVD) mortality in US adults. METHODS 35,813 adults were enrolled from the 1999-2014 National Health and Nutrition Examination Survey (NHANES) cycle. Individuals were categorized according to MLR tertiles and followed until 31 December 2019. Kaplan-Meier plots and log-rank tests were utilized to explore survival differences among the MLR tertiles. Adjusted multivariable Cox analysis was employed to investigate the relationship of MLR with mortality and CVD mortality. Restricted cubic spline and subgroup analysis were further used to discern non-linear relationship and the relationship in categories. RESULTS During a median follow-up of 134 months, 5865 (16.4%) all-cause deaths and 1602 (4.5%) cardiovascular deaths occurred. Kaplan-Meier plots revealed significant differences in all-cause and cardiovascular mortality among the MLR tertiles. In the fully-adjusted Cox regression model, individuals in the highest tertile of MLR had higher risk of mortality (HR = 1.26, 95% CI: 1.17-1.35) and CVD mortality (HR = 1.41, HR, 95% CI: 1.23-1.62) than those in the lowest tertile. The restricted cubic spline exhibited a J-shaped relationship between MLR with mortality and CVD mortality (P for non-linearity <0.001). The further subgroup analysis demonstrated a robust trend across categories. CONCLUSION Our study demonstrated that increased baseline MLR was positively associated with a higher risk of death in US adults. MLR was a strong independent predictor of mortality and CVD mortality in the general population.
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Affiliation(s)
- Yang Hua
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Jin-Yu Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Yu-Xuan Lou
- Southeast University, Nanjing, Jiangsu, China
| | - Wei Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China.
| | - Xiang-Qing Kong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China.
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Palabiyik O, Tomak Y, Acar M, Erkorkmaz U, Tuna AT, Suner KO, Ceylan D. Relationship between platelet indices and red cell distribution width and short-term mortality in traumatic brain injury with 30-day mortality. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:18-23. [PMID: 36820710 PMCID: PMC9937619 DOI: 10.1590/1806-9282.00210889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 09/12/2022] [Indexed: 02/19/2023]
Abstract
OBJECTIVE This study aimed at investigating whether there is a relationship between 7- or 30-day mortality and mean platelet volume, platelet distribution width, platelet count-to-total lymphocyte count ratio, or red cell distribution width in patients with traumatic brain injury. METHODS We retrospectively analyzed intensive care unit patients with traumatic brain injury. We recorded patients' ages; genders; diagnoses; Glasgow Coma Scale scores; length of intensive care unit stay (in days); mean platelet volume, platelet distribution width, platelet count-to-total lymphocyte count ratio, and red cell distribution width values upon hospital admission; and health on the 7th and 30th days of their stays. RESULTS We analyzed data from 110 patients. Of these, 84 (76.4%) were male and 26 (23.6%) were female. On the 7- and 30-day mortality evaluations, compared to the living patients, the deceased patients had a significantly higher median age and a significantly lower median Glasgow Coma Scale. Thus, increased age and lower Glasgow Coma Scale scores were associated with increased 7- and 30-day mortality rates. mean platelet volume and platelet distribution width values were similar in living and deceased patients. platelet count-to-total lymphocyte count ratio values were lower in deceased patients, but this difference was not statistically significant. Within 30 days after traumatic brain injury, deceased patients' red cell distribution width values were significantly elevated in deceased patients compared to those of living patients. CONCLUSION Mean platelet volume, platelet distribution width, and platelet count-to-total lymphocyte count ratio values were not associated with 7- and 30-day mortality, whereas only elevated red cell distribution width was associated with 30-day mortality.
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Affiliation(s)
- Onur Palabiyik
- Sakarya University, Faculty of Medicine, Department of Anesthesiology and Reanimation – Sakarya, Turkey.,Corresponding author:
| | - Yakup Tomak
- Dogus University, Hisar Intercontinental Hospital, Department of Anesthesiology and Reanimation – İstanbul, Turkey
| | - Muberra Acar
- Istanbul Umraniye Training and Research Hospital, Department of Anesthesiology and Reanimation – İstanbul, Turkey
| | - Unal Erkorkmaz
- Sakarya University, Faculty of Medicine, Department of Biostatistics – Sakarya, Turkey
| | - Ayca Tas Tuna
- Sakarya University, Faculty of Medicine, Department of Anesthesiology and Reanimation – Sakarya, Turkey
| | - Kezban Ozmen Suner
- Sakarya University Training and Research Hospital, Department of Intensive Care – Sakarya, Turkey
| | - Davut Ceylan
- Sakarya University, Faculty of Medicine, Department of Neurosurgery – Sakarya, Turkey
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Lengvenyte A, Strumila R, Belzeaux R, Aouizerate B, Dubertret C, Haffen E, Llorca PM, Roux P, Polosan M, Schwan R, Walter M, D'Amato T, Januel D, Leboyer M, Bellivier F, Etain B, Navickas A, Olié E, Courtet P. Associations of white blood cell and platelet counts with specific depressive symptom dimensions in patients with bipolar disorder: Analysis of data from the FACE-BD cohort. Brain Behav Immun 2023; 108:176-187. [PMID: 36494046 DOI: 10.1016/j.bbi.2022.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/21/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022] Open
Abstract
Evidences suggest that inflammation is increased in a subgroup of patients with depression. Moreover, increased peripheral inflammatory markers (cells and proteins) are associated with some, but not all depressive symptoms. On the other hand, similar studies on bipolar disorders mainly focused on blood cytokines. Here, we analysed data from a large (N = 3440), well-characterized cohort of individuals with bipolar disorder using Kendall partial rank correlation, multivariate linear regression, and network analyses to determine whether peripheral blood cell counts are associated with depression severity, its symptoms, and dimensions. Based on the self-reported 16-Item Quick Inventory of Depressive Symptomatology questionnaire scores, we preselected symptom dimensions based on literature and data-driven principal component analysis. We found that the counts of all blood cell types were only marginally associated with depression severity. Conversely, white blood cell count was significantly associated with the sickness dimension and its four components (anhedonia, slowing down, fatigue, and appetite loss). Platelet count was associated with the insomnia/restlessness dimension and its components (initial, middle, late insomnia and restlessness). Principal component analyses corroborated these results. Platelet count was also associated with suicidal ideation. In analyses stratified by sex, the white blood cell count-sickness dimension association remained significant only in men, and the platelet count-insomnia/restlessness dimension association only in women. Without implying causation, these results suggest that peripheral blood cell counts might be associated with different depressive symptoms in individuals with bipolar disorder, and that white blood cells might be implicated in sickness symptoms and platelets in insomnia/agitation and suicidal ideation.
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Affiliation(s)
- Aiste Lengvenyte
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania; Fondation FondaMental, France.
| | - Robertas Strumila
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
| | - Raoul Belzeaux
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; Fondation FondaMental, France; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France; INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - Bruno Aouizerate
- Fondation FondaMental, France; Centre Hospitalier Charles Perrens, Bordeaux, France; Laboratoire NutriNeuro (UMR INRA 1286), Université de Bordeaux, Bordeaux, France
| | - Caroline Dubertret
- Fondation FondaMental, France; Université Paris Cité, Paris, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France; Université de Paris, Inserm UMR1266, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Emmanuel Haffen
- Fondation FondaMental, France; Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, UFC, UBFC, Besançon, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, France; Centre Hospitalier et Universitaire, Département de Psychiatrie, Clermont-Ferrand, France; Université d'Auvergne, EA 7280 Clermont-Ferrand, France
| | - Paul Roux
- Fondation FondaMental, France; Université Paris-Saclay, UVSQ, CESP UMR1018, DevPsy-DisAP, Centre Hospitalier de Versailles, Pôle de Psychiatrie et Santé Mentale, 78157 Le Chesnay, France
| | - Mircea Polosan
- Fondation FondaMental, France; Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Raymund Schwan
- Fondation FondaMental, France; Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1254, Nancy, France
| | - Michel Walter
- Fondation FondaMental, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02, CHRU de Brest, Hôpital de Bohars, Brest, France
| | - Thierry D'Amato
- Fondation FondaMental, France; University Lyon 1, Villeurbanne, France; INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France
| | - Dominique Januel
- Fondation FondaMental, France; Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France
| | - Marion Leboyer
- Fondation FondaMental, France; Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, Créteil, France; AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - Frank Bellivier
- Fondation FondaMental, France; Université Paris Cité, Paris, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France; Université Paris Cité, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - Bruno Etain
- Fondation FondaMental, France; Université Paris Cité, Paris, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France; Université Paris Cité, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - Alvydas Navickas
- Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; Fondation FondaMental, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; Fondation FondaMental, France
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Dourmashkin LH, Lyons B, Hess RS, Walsh K, Silverstein DC. Evaluation of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in critically ill dogs. J Vet Emerg Crit Care (San Antonio) 2023; 33:52-58. [PMID: 36573635 DOI: 10.1111/vec.13269] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/24/2022] [Accepted: 02/07/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are accurate prognostic indicators and correlate with illness severity scores in critically ill dogs. DESIGN Prospective observational study from December 2016 to May 2017. SETTING ICU at a veterinary teaching hospital. ANIMALS Seventy-two client-owned dogs admitted to the ICU with CBCs and abbreviated and complete acute patient physiologic and laboratory evaluation (APPLEfast and APPLEfull ) scores were enrolled. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The NLR, PLR, APPLEfast , and APPLEfull scores were calculated for each patient on the day of admission. Patients were followed from admission to discharge, and diagnosis, survival, and length of hospitalization were recorded. The patient population was assessed as a whole and as subcategories of patients with neoplastic disease, infectious disease, sepsis, and severe hemorrhage. Dogs with nonseptic disease processes (n = 52) that died had a significantly higher median PLR (P = 0.04) of 441 (range: 106-986) compared to those that survived with a median PLR of 217 (range: 28.4-3225). The PLR was strongly predictive of ICU length of stay in dogs with severe hemorrhage (P = 0.03, Spearman's rho = 0.84). The NLR had a poor positive correlation with APPLEfull score (P = 0.04, Spearman's rho = 0.24), and PLR had a poor negative correlation with APPLEfast score (P = 0.02, Spearman's rho = -0.27). CONCLUSIONS The PLR correlated with ICU length of stay for patients with severe hemorrhage and with survival for patients with nonseptic disease processes. The PLR and NLR correlated with illness severity as measured by APPLE scores. Future studies with larger sample sizes are warranted to further determine the merit of NLR and PLR as indicators of morbidity, mortality, and illness severity.
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Affiliation(s)
- Lisa H Dourmashkin
- Department of Clinical Studies and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Bridget Lyons
- Emergency and Critical Care, Cornell University Veterinary Specialists, Columbia, Missouri, USA
| | - Rebecka S Hess
- Department of Clinical Studies and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Koranda Walsh
- Department of Clinical Studies and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Deborah C Silverstein
- Department of Clinical Studies and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Chen JH, Zhou H, Zhang Q, Wang H, Hidig SM, Chen XY, Feng S. Diagnostic value of mean platelet volume combined with thromboelastography for coagulation state after total knee arthroplasty. Clin Hemorheol Microcirc 2023; 84:321-331. [PMID: 37212090 DOI: 10.3233/ch-231802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND The main objective of this study was to predict the status of blood and the occurrence of lower limb deep vein thrombosis (DVT) after total knee arthroplasty(TKA) by means of mean platelet volume (MPV) combined with thromboelastography (TEG). METHODS We collected 180 patients who underwent unilateral total knee arthroplasty between May 2015 and March 2022, and the patients were divided into DVT group and control group according to whole-leg ultrasonography on the seventh postoperative day. Blood count and TEG were performed on the day before surgery, the first day after surgery and the seventh day respectively. Multifactorial analysis was used to investigate whether the relevant parameters were independent predictors of DVT after TKA. RESULTS MPV has the strongest correlation with the maximum amplitude (MA), followed by alpha-angle; MPV and alpha-angle on the first postoperative day are independent predictors of DVT. MPV in patients with thrombosis tends to rise and then fall in the perioperative period. The optimal threshold for MPV to predict thrombosis is 10.85 fL and the area under the ROC curve is 0.694, The area under the ROC curve increases to 0.815 using MPV combined with alpha-angle. In addition, MA, α-angle, composite coagulation index (CI) and MPV were all statistically higher in the DVT group than in the control group (p < 0.001). CONCLUSION MPV is a predictor of DVT after TKA. It can reflect the hypercoagulable state of blood after surgery; Combination of MPV and alpha-angle on the first day after surgery in patients with TKA improves predictive power of DVT.
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Affiliation(s)
- Jia-Hao Chen
- Department of Orthopedic Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Hang Zhou
- Department of Orthopedic Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Qiang Zhang
- Department of Orthopedic Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Hu Wang
- Department of Orthopedic Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Sakarie Mustafe Hidig
- Department of Orthopedic Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiang-Yang Chen
- Department of Orthopedic Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Shuo Feng
- Department of Orthopedic Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
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van Rensburg J, Davids S, Smuts C, Davison GM. Use of full blood count parameters and haematology cell ratios in screening for sepsis in South Africa. Afr J Lab Med 2023; 12:2104. [PMID: 37151816 PMCID: PMC10157447 DOI: 10.4102/ajlm.v12i1.2104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/31/2023] [Indexed: 05/09/2023] Open
Abstract
Background Sepsis is characterised by multi-organ failure due to an uncontrolled immune response to infection. Sepsis prevalence is increased in developing countries and requires prompt diagnosis and treatment. Reports, although controversial, suggest that full blood count parameters and cell ratios could assist in the early screening for sepsis. Objective The study evaluated the use of haematological cell ratios in screening for sepsis in a South African population. Methods The study retrospectively analysed the complete blood counts, blood cultures (BC) and biochemical test results of 125 adult patients who presented between January 2021 and July 2021 at a hospital in Cape Town. An ISO15189-accredited laboratory performed all of the tests. We compared and correlated the automated differential counts, neutrophil, monocyte and platelet-to-lymphocyte ratios with procalcitonin levels. A p-value of < 0.05 was considered significant. Results Sixty-two sepsis patients (procalcitonin > 2 ng/L and positive BC) were identified and compared to 63 non-sepsis controls. All cell ratios were significantly elevated in sepsis patients (p < 0.001). However, the two groups had no significant difference in absolute monocyte counts (p = 0.377). In addition, no correlation was detected between any cell ratios and procalcitonin. Conclusion In combination with complete blood count parameters, haematology cell ratios can be used for early sepsis detection. The full blood count is widely available, inexpensive, and routinely requested by emergency care clinicians. Although procalcitonin and BC remain the gold standard, the calculation of cell ratios could provide a simple screening tool for the early detection of sepsis. What this study adds This study adds evidence to the proposal that calculating haematological cell ratios assists in the early screening of sepsis in a South African setting.
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Affiliation(s)
- Jason van Rensburg
- Department of Biomedical Sciences, Faculty of Health and Wellness, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Saarah Davids
- South African Medical Research Council/Cape Peninsula University of Technology Cardiometabolic Health Research Unit and Biomedical Sciences, Faculty of Health and Wellness, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Carine Smuts
- Department of Biomedical Sciences, Faculty of Health and Wellness, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Glenda M Davison
- South African Medical Research Council/Cape Peninsula University of Technology Cardiometabolic Health Research Unit and Biomedical Sciences, Faculty of Health and Wellness, Cape Peninsula University of Technology, Cape Town, South Africa
- Division of Haematology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Shan C, Yu F, Deng X, Ni L, Luo X, Li J, Cai S, Huang M, Wang X. Biogenesis aberration: One of the mechanisms of thrombocytopenia in COVID-19. Front Physiol 2023; 14:1100997. [PMID: 37020458 PMCID: PMC10067878 DOI: 10.3389/fphys.2023.1100997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/02/2023] [Indexed: 04/07/2023] Open
Abstract
Background: The pathogenesis of COVID-19, including thrombocytopenia, has not been fully clarified. The lungs are a major organ of platelet production and thrombocytopenia induced by severe COVID-19 was proposed. Methods: the change of platelet level was analysed with clinical parameters in 95 hospitalized COVID-19 patients in Wuhan Third Hospital. The production of platelets in the lungs was explored in an ARDS rat model. Results: The level of platelets was negatively correlated with disease severity and was recovered with disease improvement. The non-survivors were accompanied by lower levels of platelet. The odds ratio (OR) of the valley level of the platelet count (PLTlow) was greater than 1, suggesting that PLTlow could be a death exposure factor. The platelet/lymphocyte ratio (PLR) was positively associated with severity of COVID-19, and the platelet/lymphocyte ratio threshold of 248.5 was best correlated with death risk (sensitivity 0.641 and specificity 0.815). To demonstrate the possible biogenesis aberration of platelet in lungs, an LPS-induced ARDS rat model was applied. Lower level of platelet in peripheral and less production of platelet from lungs in ARDS were demonstrated. Though megakaryocyte (MK) number in ARDS lungs is higher than controls, the immature platelet fraction (IPF) in postpulmonary blood is still at the same level as prepulmonary in ARDS rat, indicating that ARDS rats generated fewer platelets in lungs. Conclusion: Our data suggested that COVID-19-induced severe lung inflammation may impair platelet production in the lung. Thrombocytopenia may be mainly caused by platelet consumption for multiorgan thrombosis; however, biogenesis aberration of platelet in the lung induced by diffuse interstitial pulmonary damage cannot be ruled out.
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Affiliation(s)
- Cuiting Shan
- Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Feng Yu
- Shanghai Putuo District People’s Hospital, Shanghai, China
| | - Xuemei Deng
- Department of Neurology, Wuhan Third Hospital, China and Tongren Hospital of Wuhan University, Wuhan, Hubei, China
| | - Li Ni
- Shanghai Putuo District People’s Hospital, Shanghai, China
| | - Xuming Luo
- Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jialin Li
- Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Si Cai
- Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mian Huang
- Department of Neurology, Wuhan Third Hospital, China and Tongren Hospital of Wuhan University, Wuhan, Hubei, China
- *Correspondence: Xiongbiao Wang, ; Mian Huang,
| | - Xiongbiao Wang
- Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Xiongbiao Wang, ; Mian Huang,
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Liu S, Szatmary P, Lin JW, Wang Q, Sutton R, Chen L, Liu T, Huang W, Xia Q. Circulating monocytes in acute pancreatitis. Front Immunol 2022; 13:1062849. [PMID: 36578487 PMCID: PMC9791207 DOI: 10.3389/fimmu.2022.1062849] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
Acute pancreatitis is a common gastrointestinal disease characterized by inflammation of the exocrine pancreas and manifesting itself through acute onset of abdominal pain. It is frequently associated with organ failure, pancreatic necrosis, and death. Mounting evidence describes monocytes - phagocytic, antigen presenting, and regulatory cells of the innate immune system - as key contributors and regulators of the inflammatory response and subsequent organ failure in acute pancreatitis. This review highlights the recent advances of dynamic change of numbers, phenotypes, and functions of circulating monocytes as well as their underling regulatory mechanisms with a special focus on the role of lipid modulation during acute pancreatitis.
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Affiliation(s)
- Shiyu Liu
- West China Centre of Excellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Peter Szatmary
- Liverpool Pancreatitis Research Group, Liverpool University Hospitals NHS Foundation Trust and Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Jing-wen Lin
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Qiqi Wang
- West China Centre of Excellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Robert Sutton
- Liverpool Pancreatitis Research Group, Liverpool University Hospitals NHS Foundation Trust and Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Lu Chen
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Tingting Liu
- West China Centre of Excellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Tingting Liu, ; Wei Huang, ; Qing Xia,
| | - Wei Huang
- West China Centre of Excellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu, China,Institutes for Systems Genetics & Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Tingting Liu, ; Wei Huang, ; Qing Xia,
| | - Qing Xia
- West China Centre of Excellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Tingting Liu, ; Wei Huang, ; Qing Xia,
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Chelariu AC, Coman AE, Lionte C, Gorciac V, Sorodoc V, Haliga RE, Petris OR, Bologa C, Puha G, Stoica A, Constantin M, Sirbu O, Ceasovschih A, Sorodoc L. The Value of Early and Follow-Up Elevated Scores Based on Peripheral Complete Blood Cell Count for Predicting Adverse Outcomes in COVID-19 Patients. J Pers Med 2022; 12:jpm12122037. [PMID: 36556258 PMCID: PMC9781715 DOI: 10.3390/jpm12122037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/20/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Background: The ongoing COVID-19 pandemic has put a constant strain on hospital resources, so there is a dire need for investigation methods that are widely available and that can predict mortality and the need for critical care. Hematological indices, which can be easily calculated from a complete blood count (CBC), are useful in determining a patient’s inflammatory response to infectious diseases. Aim: This was a prospective cohort study that aimed to assess the prognostic value of scores based on CBCs in hospitalized patients with mild or moderate COVID-19 and medical comorbidities regarding the need for intensive care unit (ICU) therapy and short-term mortality. Methods: We included 607 patients with confirmed COVID-19, followed up for the need for ICU admission (15.5%) and 30 day mortality post-discharge (21.7%). CBC-derived scores were tested upon emergency department (ED) admission and after a median of 8 days. Results: In a multivariate model, elevated followed-up neutrophil-to-lymphocyte ratio (NLR) predicted increased odds for ICU admission (OR: 1.14 [95%CI: 1.06−1.22], p < 0.001) and short-term mortality (OR: 1.30 [95%CI: 1.09−1.57], p = 0.005). Monocyte-to-lymphocyte ratio (MLR) predicted 2.5-fold increased odds for ICU admission and 2.2-fold increased odds for mortality. Conclusion: NLR and MLR followed up 8 days post-admission are predictive for adverse outcomes in mild or moderate COVID-19 patients.
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Affiliation(s)
- Andrei-Costin Chelariu
- Hematology Department, Regional Institute of Oncology, 700483 Iasi, Romania
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
| | - Adorata Elena Coman
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Preventive Medicine and Interdisciplinarity Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Catalina Lionte
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
- Correspondence: (C.L.); (V.S.)
| | - Victoria Gorciac
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
- Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Victorita Sorodoc
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
- Correspondence: (C.L.); (V.S.)
| | - Raluca Ecaterina Haliga
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Ovidiu Rusalim Petris
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
- Nursing Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Cristina Bologa
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Gabriela Puha
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Alexandra Stoica
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Mihai Constantin
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Oana Sirbu
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Alexandr Ceasovschih
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Laurentiu Sorodoc
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
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Duan Y, Peng Z, Zhong S, Huang H, He Z. Association between subclinical left ventricular ejection fraction and platelet-to-lymphocyte ratio in patients with peritoneal dialysis. Front Med (Lausanne) 2022; 9:961453. [DOI: 10.3389/fmed.2022.961453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2022] Open
Abstract
BackgroundReduced left ventricular ejection function (LVEF) was associated with increased mortality in patients with peritoneal dialysis (PD) in Asia and the United States of America. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were correlated with LVEF in PD. However, little information is available regarding the relationship between monocyte-to-lymphocyte ratio (MLR), left ventricular ejection fraction (LVEF), and the use of NLR, PLR, and MLR in predicting left ventricular systolic dysfunction (LVSD) in patients with PD.MethodsAll 181 patients with PD were enrolled between 2014 and 2021 from the Nephrology Department of the First Affiliated Hospital of the University of South China. Demographic features, clinical characteristics, laboratory values, and echocardiographic parameters were collected.ResultsThe mean age of patients with PD was 47.4 ± 12.6, and 90 (49.7%) of the patients were men. LVEF showed a negative correlation with PLR (r = −0.200, p = 0.007) and MLR (r = −0.146, p = 0.049). The levels of NLR, PLR, and MLR were elevated in patients with PD with LVSD compared with those without (all p < 0.05). PLR (OR 4.331, 95% CI: 1.223, 15.342) and albumin (OR 13.346, 95% CI: 3.928, 45.346) were significantly associated with LVSD patients with PD in the multivariate logistic analysis. For differentiating patients with PD with LVSD, optimal cutoffs of NLR, PLR, MLR, and albumin were 4.5 (sensitivity: 76.7%, specificity: 55.0%, and overall accuracy: 58%), 202.6 (sensitivity: 66.7%, specificity: 69.5%, and overall accuracy: 69%), 0.483 (sensitivity: 53.3%, specificity: 72.8%, and overall accuracy: 30%), and 34.6 (sensitivity: 72.2%), respectively.ConclusionsOur results revealed that PLR was better than NLR, MLR, and albumin in predicting LVSD in PD.
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Velasco-Arnaiz E, Batllori M, Monsonís M, Valls A, Ríos-Barnes M, Simó-Nebot S, Gamell A, Fortuny C, Tebruegge M, Noguera-Julian A. Host, technical, and environmental factors affecting QuantiFERON-TB Gold In-Tube performance in children below 5 years of age. Sci Rep 2022; 12:19908. [PMID: 36402803 PMCID: PMC9675832 DOI: 10.1038/s41598-022-24433-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022] Open
Abstract
Interferon-gamma release assays performance can be impaired by host-related, technical and environmental factors, but data in young children are limited. We performed a cross-sectional study of children < 5 years-of-age at risk of tuberculosis (TB), using QuantiFERON-TB Gold In-Tube (QFT-GIT) assays. The impact of the following was evaluated: (i) host-related [age; hematological parameters; erythrocyte sedimentation rate (ESR); C-reactive protein (CRP); and tobacco smoke exposure (TSE) based on serum cotinine concentrations], (ii) technical (pre-analytical delay) and (iii) environmental factors (annual season; monthly temperatures). Of 204 children, 35 (17.2%) were diagnosed with latent TB infection or TB disease. QFT-GIT results were indeterminate in 14 (6.9%) patients. In multivariate analysis, younger age and higher ESR were associated with lower positive control responses (beta: 0.247, p = 0.002 and - 0.204, p = 0.007, respectively), and increasing age was associated with lower rates of indeterminate QFT-GIT results [OR (95% CI) 0.948 (0.903-0.996) per month, p = 0.035]. In children with positive QFT-GIT results, average monthly temperatures correlated with antigen responses (r = 0.453, p = 0.020); also, antigen responses were lower in winter than in other seasons (p = 0.027). Serum cotinine concentrations determined in a subgroup of patients (n = 41) indicated TSE in 36 (88%), positive control responses being lower in children with TSE (p = 0.034). In children < 5 years-of-age, young age, elevated ESR, temperature, annual season and TSE can affect the performance of QFT-GIT assays.
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Affiliation(s)
- Eneritz Velasco-Arnaiz
- grid.411160.30000 0001 0663 8628Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria; Servei d’Infectologia Pediàtrica, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Marta Batllori
- grid.411160.30000 0001 0663 8628Laboratori de Bioquímica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Manuel Monsonís
- grid.411160.30000 0001 0663 8628Servei de Microbiologia. Hospital Sant Joan de Déu, Barcelona, Spain
| | - Anna Valls
- grid.411160.30000 0001 0663 8628Laboratori de Bioquímica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - María Ríos-Barnes
- grid.411160.30000 0001 0663 8628Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria; Servei d’Infectologia Pediàtrica, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Sílvia Simó-Nebot
- grid.411160.30000 0001 0663 8628Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria; Servei d’Infectologia Pediàtrica, Institut de Recerca Sant Joan de Déu, Barcelona, Spain ,grid.466571.70000 0004 1756 6246CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Anna Gamell
- grid.411160.30000 0001 0663 8628Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria; Servei d’Infectologia Pediàtrica, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Clàudia Fortuny
- grid.411160.30000 0001 0663 8628Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria; Servei d’Infectologia Pediàtrica, Institut de Recerca Sant Joan de Déu, Barcelona, Spain ,grid.466571.70000 0004 1756 6246CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain ,grid.5841.80000 0004 1937 0247Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain ,Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Marc Tebruegge
- grid.83440.3b0000000121901201Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, UK ,grid.1008.90000 0001 2179 088XDepartment of Pediatrics, University of Melbourne, Parkville, Australia ,Department of Paediatrics, Klinik Ottakring, Wiener Gesundheitsverbund, Vienna, Austria
| | - Antoni Noguera-Julian
- grid.411160.30000 0001 0663 8628Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria; Servei d’Infectologia Pediàtrica, Institut de Recerca Sant Joan de Déu, Barcelona, Spain ,grid.466571.70000 0004 1756 6246CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain ,grid.5841.80000 0004 1937 0247Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain ,Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain ,grid.411160.30000 0001 0663 8628Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, Esplugues de Llobregat, 08950 Barcelona, Spain
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Shi Y, Yang C, Chen L, Cheng M, Xie W. Predictive value of neutrophil-to-lymphocyte and platelet ratio in in-hospital mortality in septic patients. Heliyon 2022; 8:e11498. [DOI: 10.1016/j.heliyon.2022.e11498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/14/2022] [Accepted: 11/03/2022] [Indexed: 11/17/2022] Open
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NLR, MLR, PLR and RDW to predict outcome and differentiate between viral and bacterial pneumonia in the intensive care unit. Sci Rep 2022; 12:15974. [PMID: 36153405 PMCID: PMC9509334 DOI: 10.1038/s41598-022-20385-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/13/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractThe neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) are emerging biomarkers to predict outcomes in general ward patients. However, their role in the prognostication of critically ill patients with pneumonia is unclear. A total of 216 adult patients were enrolled over 2 years. They were classified into viral and bacterial pneumonia groups, as represented by influenza A virus and Streptococcus pneumoniae, respectively. Demographics, outcomes, and laboratory parameters were analysed. The prognostic power of blood parameters was determined by the respective area under the receiver operating characteristic curve (AUROC). Performance was compared using the APACHE IV score. Discriminant ability in differentiating viral and bacterial aetiologies was examined. Viral and bacterial pneumonia were identified in 111 and 105 patients, respectively. In predicting hospital mortality, the APACHE IV score was the best prognostic score compared with all blood parameters studied (AUC 0.769, 95% CI 0.705–0.833). In classification tree analysis, the most significant predictor of hospital mortality was the APACHE IV score (adjusted P = 0.000, χ2 = 35.591). Mechanical ventilation was associated with higher hospital mortality in patients with low APACHE IV scores ≤ 70 (adjusted P = 0.014, χ2 = 5.999). In patients with high APACHE IV scores > 90, age > 78 (adjusted P = 0.007, χ2 = 11.221) and thrombocytopaenia (platelet count ≤ 128, adjusted P = 0.004, χ2 = 12.316) were predictive of higher hospital mortality. The APACHE IV score is superior to all blood parameters studied in predicting hospital mortality. The single inflammatory marker with comparable prognostic performance to the APACHE IV score is platelet count at 48 h. However, there is no ideal biomarker for differentiating between viral and bacterial pneumonia.
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