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Neutrophil-lymphoycyte-ratio, platelet-lymphocyte-ratio and procalcitonin for early assessment of prognosis in patients undergoing VA-ECMO.

ABSTRACT: The use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasing, but mortality remains high. Early assessment of prognosis is challenging and valid markers are lacking. This study aimed to investigate Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte-Ratio (PLR) and Procalcitonin (PCT) for early assessment of prognosis in patients undergoing VA-ECMO. This retrospective single-center cohort study included 344 consecutive patients ≥ 18 years who underwent VA-ECMO due to cardiogenic shock. Main exposures were NLR, PLR and PCT measured within 24 h after VA-ECMO initiation. The primary endpoint was all-cause in-hospital mortality. In total, 92 patients were included into final analysis (71.7% male, age 57 ± 14 years). In-hospital mortality rate was 48.9%. Receiver operating characteristics (ROC) curve revealed an area under the curve (AUC) of 0.65 [95% confidence interval (CI) 0.53-0.76] for NLR. The AUCs of PLR and PCT were 0.47 [95%CI 0.35-0.59] and 0.54 [95%CI 0.42-0.66], respectively. Binary logistic regression showed an adjusted odds ratio of 3.32 [95%CI 1.13-9.76] for NLR, 1.0 [95%CI 0.998-1.002] for PLR and 1.02 [95%CI 0.99-1.05] for PCT. NLR is independently associated with in-hospital mortality in patients undergoing VA-ECMO. However, discriminative ability is weak. PLR and PCT seem not to be suitable for this purpose.

SUBMITTER: Roth S

PROVIDER: S-EPMC8752603 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Neutrophil-lymphoycyte-ratio, platelet-lymphocyte-ratio and procalcitonin for early assessment of prognosis in patients undergoing VA-ECMO.

Roth Sebastian S M'Pembele René R Stroda Alexandra A Jansen Catrin C Lurati Buse Giovanna G Boeken Udo U Akhyari Payam P Lichtenberg Artur A Hollmann Markus W MW Huhn Ragnar R Aubin Hug H

Scientific reports 20220111 1

The use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasing, but mortality remains high. Early assessment of prognosis is challenging and valid markers are lacking. This study aimed to investigate Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte-Ratio (PLR) and Procalcitonin (PCT) for early assessment of prognosis in patients undergoing VA-ECMO. This retrospective single-center cohort study included 344 consecutive patients ≥ 18 years who underwent VA-ECMO due to c ...[more]

PMID: 35017601

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Project description:Inflammation and immunoreaction markers were correlated with the survival of patients in many tumors. However, there were no reports investigating the relationships between preoperative hematological markers and the prognosis of medulloblastoma (MB) patients based on the molecular subgroups (WNT, SHH, Group 3, and Group 4). A total 144 MB patients were enrolled in the study. The differences of preoperative hematological markers among molecular subgroups of MB were compared by One-way ANOVA method. Kaplan-Meier method was used to calculate the curves of progression free survival (PFS) and overall survival (OS). The comparison of survival rates in different groups were conducted by the Log-rank test. Multivariate analysis was used to evaluate independent prognostic factors. Increased preoperative NLR (neutrophil-to-lymphocyte ratio, PFS, P = 0.004, OS, P < 0.001) and PLR (platelet-to-lymphocyte ratio, PFS, P = 0.028, OS, P = 0.003) predicted poor prognosis in patients with MB, while preoperative MLR (monocyte-to-lymphocyte ratio), MPV (mean platelet volume), PDW (platelet distribution width), and AGR (albumin-to-globulin ratio) were revealed no predictive value on the prognosis of patients with MB. Furthermore, high preoperative NLR and PLR predicted unfavorable prognosis in childhood MB patients. However, preoperative NLR and PLR were not associated with the prognosis in adult MB patients. Multivariate analysis demonstrated preoperative NLR (PFS, P = 0.029, OS, P = 0.005) and PLR (PFS, P = 0.023, OS, P = 0.005) were the independent prognostic factors in MB patients. Emphatically, the levels of preoperative NLR and PLR in Group 3 MB were significantly higher than those in WNT MB. High preoperative NLR was associated with unfavorable OS in Group 3 (P = 0.032) and Group 4 (P = 0.027) tumors. Similarly, increased preoperative PLR predicted poor PFS (P = 0.012) and OS (P = 0.009) in Group 4 tumors. Preoperative NLR and PLR were the potential prognostic markers for MB patients. Preoperative NLR and PLR were significantly associated with the survival of Group 3 and Group 4 tumors.

Project description:ObjectiveTo evaluate the diagnostic value of the expression of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in distinguishing endometrial cancer from benign uterine lesions.MethodsIn this retrospective analysis, clinical data were collected from 112 patients treated at Hengshui People's Hospital (Harrison International Peace Hospital) between January 2022 and December 2023. The cohort comprised 56 patients diagnosed with endometrial cancer and 56 patients with benign uterine lesions, matched 1:1. Demographic details, comorbidities, and serological parameters - including WBC, RBC, Hb, MPV, neutrophil, lymphocyte, monocyte, and platelet counts - were recorded. NLR, LMR, and PLR values were subsequently calculated.ResultsSignificant serological differences were observed between the endometrial cancer and benign lesion groups, including NLR (4.25 ± 1.23 vs. 2.18 ± 0.95, P < 0.001), LMR (3.12 ± 0.98 vs. 5.08 ± 1.75, P < 0.001), and PLR (201.23 ± 45.66 vs. 150.27 ± 30.45, P < 0.001). Correlation analysis indicated a strong association between endometrial cancer and NLR (r = 0.689, P < 0.001), LMR (r = -0.572, P < 0.001), and PLR (r = 0.552, P < 0.001). ROC analysis demonstrated that NLR (AUC = 0.91) offered superior diagnostic value relative to LMR (AUC = 0.841) and PLR (AUC = 0.83). Logistic regression identified significant associations for NLR ≥ 3.4 (OR = 69.173, P < 0.001), LMR ≥ 4.055 (OR = 0.048, P < 0.001), and PLR ≥ 150.445 (OR = 18.134, P = 0.002). DeLong's test revealed no significant differences in diagnostic performance among the ratios (NLR vs. LMR, P = 0.149; NLR vs. PLR, P = 0.08; LMR vs. PLR, P = 0.842).ConclusionNLR, LMR, and PLR are valuable hematological markers for diagnosing endometrial cancer, with NLR demonstrating the highest sensitivity and specificity. These findings support the inclusion of these serological parameters in routine diagnostic protocols to enhance the accurate identification of endometrial cancer.

Dataset Information

Neutrophil-lymphoycyte-ratio, platelet-lymphocyte-ratio and procalcitonin for early assessment of prognosis in patients undergoing VA-ECMO.

Publications

Neutrophil-lymphoycyte-ratio, platelet-lymphocyte-ratio and procalcitonin for early assessment of prognosis in patients undergoing VA-ECMO.

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