학술논문
Prognostic value of platelet-to-lymphocyte ratios among critically ill patients with acute kidney injury
Document Type
Report
Author
Source
Critical Care. September 8, 2017, Vol. 21 Issue 1
Subject
Language
English
ISSN
1364-8535
Abstract
Author(s): Chen-Fei Zheng[sup.1] , Wen-Yue Liu[sup.2] , Fang-Fang Zeng[sup.3,4] , Ming-Hua Zheng[sup.5] , Hong-Ying Shi[sup.6] , Ying Zhou[sup.7] and Jing-Ye Pan[sup.8] Background More than 5 million patients are admitted to [...]
Background Inflammation plays an important role in the initiation and progression of acute kidney injury (AKI). However, evidence regarding the prognostic effect of the platelet-to-lymphocyte ratio (PLR), a novel systemic inflammation marker, among patients with AKI is scarce. In this study, we investigated the value of the PLR in predicting the outcomes of critically ill patients with AKI. Methods Patient data were extracted from the Multiparameter Intelligent Monitoring in Intensive Care Database III version 1.3. PLR cutoff values were determined using smooth curve fitting or quintiles and were used to categorize the subjects into groups. The clinical outcomes were 30-day and 90-day mortality in the intensive care unit (ICU). Cox proportional hazards models were used to evaluate the association between the PLR and survival. Results A total of 10,859 ICU patients with AKI were enrolled. A total of 2277 thirty-day and 3112 ninety-day deaths occurred. A U-shaped relationship was observed between the PLR and both 90-day and 30-day mortality, with the lowest risk being at values ranging from 90 to 311. The adjusted HR (95% CI) values for 90-day mortality given risk values < 90 and > 311 were 1.25 (1.12-1.39) and 1.19 (1.08-1.31), respectively. Similar trends were observed for 30-day mortality or when quintiles were used to group patients according to the PLR. Statistically significant interactions were found between the PLR and both age and heart rate. Younger patients (aged < 65 years) and those with more rapid heart rates ([greater than or equai to]89.4 beats per minute) tended to have poorer prognoses only when the PLR was < 90, whereas older patients (aged [greater than or equai to] 65 years) and those with slower heart rates ( 311 (P < 0.001 for age and P < 0.001 for heart rate). Conclusions The preoperative PLR was associated in a U-shaped pattern with survival among patients with AKI. The PLR appears to be a novel, independent prognostic marker of outcomes in critically ill patients with AKI. Keywords: Platelet-to-lymphocyte ratio, Acute kidney injury, Prognosis, Intensive care unit
Background Inflammation plays an important role in the initiation and progression of acute kidney injury (AKI). However, evidence regarding the prognostic effect of the platelet-to-lymphocyte ratio (PLR), a novel systemic inflammation marker, among patients with AKI is scarce. In this study, we investigated the value of the PLR in predicting the outcomes of critically ill patients with AKI. Methods Patient data were extracted from the Multiparameter Intelligent Monitoring in Intensive Care Database III version 1.3. PLR cutoff values were determined using smooth curve fitting or quintiles and were used to categorize the subjects into groups. The clinical outcomes were 30-day and 90-day mortality in the intensive care unit (ICU). Cox proportional hazards models were used to evaluate the association between the PLR and survival. Results A total of 10,859 ICU patients with AKI were enrolled. A total of 2277 thirty-day and 3112 ninety-day deaths occurred. A U-shaped relationship was observed between the PLR and both 90-day and 30-day mortality, with the lowest risk being at values ranging from 90 to 311. The adjusted HR (95% CI) values for 90-day mortality given risk values < 90 and > 311 were 1.25 (1.12-1.39) and 1.19 (1.08-1.31), respectively. Similar trends were observed for 30-day mortality or when quintiles were used to group patients according to the PLR. Statistically significant interactions were found between the PLR and both age and heart rate. Younger patients (aged < 65 years) and those with more rapid heart rates ([greater than or equai to]89.4 beats per minute) tended to have poorer prognoses only when the PLR was < 90, whereas older patients (aged [greater than or equai to] 65 years) and those with slower heart rates ( 311 (P < 0.001 for age and P < 0.001 for heart rate). Conclusions The preoperative PLR was associated in a U-shaped pattern with survival among patients with AKI. The PLR appears to be a novel, independent prognostic marker of outcomes in critically ill patients with AKI. Keywords: Platelet-to-lymphocyte ratio, Acute kidney injury, Prognosis, Intensive care unit