Application value of neutrophil to lymphocyte rate combined with red blood cell distribution width to platelet count ratio in emergency elderly sepsis patients
10.3760/cma.j.cn101721-20220722-000311
- VernacularTitle:中性粒细胞与淋巴细胞比值联合红细胞分布宽度与血小板计数比值在急诊老年脓毒症患者中的应用价值
- Author:
Hailong YANG
1
;
Dongli WANG
;
Jing WANG
;
Changyuan WANG
Author Information
1. 首都医科大学宣武医院急诊科，北京 100053
- Keywords:
Red blood cell distribution width to platelet count ratio;
Neutrophil to lymphocyte rate;
Procalcitonin;
APACHE Ⅱ scores;
Sepsis
- From:
Clinical Medicine of China
2022;38(6):509-514
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of neutrophil to lymphocyte rate (NLR) combined with red blood cell distribution width to platelet count ratio (RPR) in evaluating the condition and prognosis of emergency elderly sepsis patients.Methods:A prospective research method was conducted to select 169 elderly patients with sepsis who visited the emergency department of Xuanwu Hospital of Capital Medical University from January 2020 to February 2022.After admission, blood routine examination, chest computerized tomography, biochemical examination, procalcitonin, and pathogenic examination were given, and the scores of acute physiology and chronic health evaluation (APACHE Ⅱ) were scored according to worst value of 24 hours. After 28 days of follow-up, the patients were divided into the survival group(125 cases) and the death group(44 cases) according to the prognosis. The differences of white blood cell count(WBC), NLR, PCT, RPR and APACHE Ⅱ scores were compared between the two groups. The correlation between NLR,RPR and APACHE Ⅱ scores were analyzed. The difference of area under receiver operating characteristic curve (ROC) of RPR, NLR, their combination and PCT in predicting mortality were compared in elderly patients with sepsis. The independent sample t test was used to compare the measurement data with normal distribution, and the χ 2 test was used to compare the enumeration data. The risk factors were analyzed by multiple logistic regression analysis. Results:There was no significant difference in WBC between the survival group and the death group ( P=0.361). The APACHE Ⅱ scores ((18.52±2.41) points), RPR (0.17±0.03), NLR (10.64±3.48), PCT ((2.55±1.14) μg/L) in the death group were higher than those in the survival group ((14.17±2.71) points, (0.14±0.03), NLR (7.67±3.33), (1.19±0.81) μg/L), the difference was statistically significant ( t values were 9.44,7.32,4.92, and 7.32, respectively; all P<0.001). RPR and NLR were positively correlated with APACHE Ⅱ scores ( r=0.393,0.368;both P<0.001). Multivariate logistic regression analysis showed that increased NLR ( OR=1.174,95% CI 1.041-1.325), procalcitonin ( OR=4.353,95% CI 2.382-7.954), RPR ( OR=14.247,95% CI 2.635-77.025) were independent risk factors for the prognosis of sepsis patients ( P values were 0.009,<0.001, and 0.002, respectively).The area under receiver operating characteristic curve (AUC) of PCT in predicting mortality was 0.859 (95% CI:0.801-0.917), the AUC of RPR was 0.755 (95% CI:0.665-0.845), and the AUC of NLR was 0.727 (95% CI: 0.643-0.812). The AUC of RPR and NLR was smaller than that of PCT ( P=0.033, 0.015), but the AUC of RPR combined with NLR was 0.799, which had no significant difference compared with PCT ( P=0.195). Conclusion:Both NLR and RPR had a certain predictive value for the condition and prognosis of elderly sepsis patients in emergency, and their combined evaluation value was similar to that of PCT.
