Neutrophil-to-lymphocyte ratio (NLR) predicts mortality in hospitalized geriatric patients independent of the admission diagnosis: a multicenter prospective cohort study

Background The Neutrophil-to-lymphocyte ratio (NLR) is a marker of poor prognosis in hospitalized older patients with different diseases, but there is still no consensus on the optimal cut-off value to identify older patients at high-risk of in-hospital mortality. Therefore, in this study we aimed a...

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Vydáno v:Journal of translational medicine Ročník 21; číslo 1; s. 835 - 8
Hlavní autoři: Di Rosa, Mirko, Sabbatinelli, Jacopo, Soraci, Luca, Corsonello, Andrea, Bonfigli, Anna Rita, Cherubini, Antonio, Sarzani, Riccardo, Antonicelli, Roberto, Pelliccioni, Giuseppe, Galeazzi, Roberta, Marchegiani, Francesca, Iuorio, Salvatore, Colombo, Daniele, Burattini, Maurizio, Lattanzio, Fabrizia, Olivieri, Fabiola
Médium: Journal Article
Jazyk:angličtina
Vydáno: London BioMed Central 21.11.2023
BioMed Central Ltd
Springer Nature B.V
BMC
Témata:
Age
Aged
Aged patients
Albumin
Bacterial pneumonia
Biomedical and Life Sciences
Biomedicine
Blood
Cardiovascular disease
Care and treatment
Congestive heart failure
COVID-19
Creatinine
Development and progression
Diagnosis
Disease Biomarkers
Epidermal growth factor receptors
Forecasts and trends
Geriatrics
Health aspects
Heart failure
Hemoglobin
Hemoglobins
Hospital patients
Hospitalization
Hospitals
Humans
Infectious diseases
Inflammation
Laboratories
Length of Stay
Leukocytes (neutrophilic)
Lymphocytes
Measurement
Medical prognosis
Medical research
Medicine, Experimental
Medicine/Public Health
Mortality
Neutrophil-to-lymphocyte ratio
Neutrophils
NLR
Older patients
Patient outcomes
Patients
Personalized medicine
Pneumonia
Prevention
Prognosis
Prospective Studies
Sepsis
Taiwan
Type 2 diabetes
Italy
Taiwan
United States > US
Older patients
Hospitalization
Personalized medicine
NLR
Neutrophil-to-lymphocyte ratio
Mortality
ISSN:1479-5876, 1479-5876
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Shrnutí:Background The Neutrophil-to-lymphocyte ratio (NLR) is a marker of poor prognosis in hospitalized older patients with different diseases, but there is still no consensus on the optimal cut-off value to identify older patients at high-risk of in-hospital mortality. Therefore, in this study we aimed at both validating NLR as a predictor of death in older hospitalized patients and assess whether the presence of specific acute diseases can modify its predictive value. Methods This prospective cohort study included 5034 hospitalizations of older patients admitted to acute care units in the context of the ReportAge study. NLR measured at admission was considered as the exposure variable, while in-hospital mortality was the outcome of the study. ROC curves with Youden’s method and restricted cubic splines were used to identify the optimal NLR cut-off of increased risk. Cox proportional hazard models, stratified analyses, and Kaplan–Meier survival curves were used to analyse the association between NLR and in-hospital mortality. Results Both continuous and categorical NLR value (cut-off ≥ 7.95) predicted mortality in bivariate and multivariate prognostic models with a good predictive accuracy. The magnitude of this association was even higher in patients without sepsis, congestive heart failure, and pneumonia, and those with higher eGFR, albumin, and hemoglobin ( p  <  0.001).  A negative multiplicative interaction was found between NLR and eGFR < 45 ( p  =  0.001). Conclusions NLR at admission is a readily available and cost-effective biomarker that could improve identification of geriatric patients at high risk of death during hospital stay independent of admitting diagnosis, kidney function and hemoglobin levels.
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ISSN:1479-5876
1479-5876
DOI:10.1186/s12967-023-04717-z