Admission Neutrophil-Lymphocyte Ratio (NLR) Predicts Survival in Patients with Extensive Burns
Admission Neutrophil-Lymphocyte Ratio (NLR) Predicts Survival in Patients with Extensive Burns
复制标题
入院时中性粒细胞与淋巴细胞比率 (NLR) 可预测大面积烧伤患者的生存率
DOI：
10.1016/j.burns.2020.07.028
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发表时间：
2021-05-07
期刊：
影响因子：
2.7
通讯作者：
Sun, Yu
中科院分区：
文献类型：
--
作者：
Hu, Lunyang;Wang, Baoli;Sun, Yu
背景：大面积烧伤是最常见的严重创伤之一，年死亡率高。以往的研究表明，中性粒细胞与淋巴细胞的比值（NLR）是一些炎症性疾病的预后因子。然而，到目前为止，还没有研究评估NLR在大面积烧伤患者中的临床预后价值。本研究的目的是探讨NLR在这种医学状况下的预后价值，以提供临床指导。研究方法：回顾性分析长海医院烧伤外科2005年至2018年诊断为大面积烧伤的271例患者。结果：在本研究的271例患者中，大多数（82.3%）是由火焰伤害。中位全身表面积（TBSA）为55%（IQR，40%-85%），中位全层烧伤（FTB）为20%（IQR，3%-44%）。NLR在入院后3天内下降，与第28天无呼吸机天数呈负相关（r =-0.127，P = 0.048）。在多变量logistic回归分析中，较高的入院NLR独立预测较高的死亡率。根据ROC曲线，第1天（或入院日）、第2天和第3天NLR的最佳截断值分别为14、13和7.5。然后，我们进行了生存分析，发现高于截止点的NLR患者的总生存期低于截止点的NLR患者（第1、2和3天分别为p = 0.023、0.045和0.019）。
Background: Extensive burns is one of the most common severe injuries, with a high annual death rate. Previous studies showed that the neutrophil to lymphocyte ratio (NLR) is a prognostic factor for some inflammatory diseases. However, until now, no study has evaluated the clinical prognostic value of NLR in extensively burned patients. The aim of this study was to investigate the prognostic value of NLR in this medical condition to provide clinical guidance. Methods: 271 patients diagnosed with extensive burns were analysed retrospectively between 2005 and 2018 in the Department of Burn Surgery of Changhai Hospital. NLR cut-off values at the first 3 days of hospitalization were calculated by the ROC analysis.Results: Of the 271 patients in this study, the majority (82.3%) were injured by flame. The median total body surface area (TBSA) was 55% (IQR, 40% to 85%) and the median full thickness burn (FTB) was 20% (IQR, 3%-44%). The patients' NLR declined within the first 3 days after admission, and we found that NLR was negatively correlated with the ventilatorfree days at day 28 (r = -0.127, P = 0.048). In a multivariate logistic regression analysis, higher admission NLR was independently predictive of higher mortality. According to the ROC curve, the best cut-off values for day 1 (or admission day), day 2 and day 3 NLR were 14, 13 and 7.5, respectively. We then performed a survival analysis, finding that those NLR above the cut-off point had decreased overall survival compared to those with NLR below the cut-off point (p = 0.023, 0.045 and 0.019 for day 1, 2, and 3, respectively).