Neutrophil-to-lymphocyte ratio associated with an increased risk of mortality in patients with critical limb ischemia.

<h4>Purpose</h4>Association of the neutrophil-to-lymphocyte ratio (NLR) with mortality has not been comprehensively explored in critical limb ischemia (CLI) patients. We investigated the association between the NLR and clinical outcomes in CLI.<h4>Materials and methods</h4>We...

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Autores principales:	Min-I Su, Cheng-Wei Liu
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/15dfb4130b6d4813adebfa2620109fd0
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spelling	oai:doaj.org-article:15dfb4130b6d4813adebfa2620109fd02021-11-25T06:23:43ZNeutrophil-to-lymphocyte ratio associated with an increased risk of mortality in patients with critical limb ischemia.1932-620310.1371/journal.pone.0252030https://doaj.org/article/15dfb4130b6d4813adebfa2620109fd02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252030https://doaj.org/toc/1932-6203<h4>Purpose</h4>Association of the neutrophil-to-lymphocyte ratio (NLR) with mortality has not been comprehensively explored in critical limb ischemia (CLI) patients. We investigated the association between the NLR and clinical outcomes in CLI.<h4>Materials and methods</h4>We retrospectively enrolled consecutive CLI patients between 1/1/2013 and 12/31/2018. Receiver operating characteristic curve analysis determined NLR cutoffs for 1-year in-hospital, all-cause and cardiac-related mortality; major adverse cardiovascular events (MACEs); and major adverse limb events (MALEs).<h4>Results</h4>Among 195 patients (age, 74.0 years, SD: 11.5; 51.8% male; body mass index, 23.4 kg/m2, SD: 4.2), 14.4% exhibited acute limb ischemia. After 1 year, patients with NLR>8 had higher in-hospital mortality (21.1% vs. 3.6%, P<0.001), all-cause mortality (54.4% vs. 13.8%, P<0.001), cardiac-related mortality (28.1% vs. 6.5%, P<0.001), MACE (29.8% vs. 13.0%, P = 0.008), and MALE (28.1% vs. 13.0%, P = 0.021) rates than those with NLR<8. In multivariate logistic regression, NLR≥8 was significantly associated with all-cause (P<0.001) and cardiac-related (adjusted HR: 5.286, 95% CI: 2.075-13.47, P<0.001) mortality, and NLR≥6 was significantly associated with MALEs (adjusted HR: 2.804, 95% CI: 1.292-6.088, P = 0.009). Each increase in the NLR was associated with increases in all-cause (adjusted HR: 1.028, 95% CI: 1.008-1.049, P = 0.007) and cardiac-related (adjusted HR:1.027, 95% CI: 0.998-1.057, P = 0.073) mortality but not in-hospital mortality or MACEs.<h4>Conclusion</h4>CLI patients with high NLRs had significantly higher risks of 1-year all-cause and cardiac-related mortality and MALEs. The NLR can be used for prognostic prediction in these patients.Min-I SuCheng-Wei LiuPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0252030 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Min-I Su Cheng-Wei Liu Neutrophil-to-lymphocyte ratio associated with an increased risk of mortality in patients with critical limb ischemia.
description	<h4>Purpose</h4>Association of the neutrophil-to-lymphocyte ratio (NLR) with mortality has not been comprehensively explored in critical limb ischemia (CLI) patients. We investigated the association between the NLR and clinical outcomes in CLI.<h4>Materials and methods</h4>We retrospectively enrolled consecutive CLI patients between 1/1/2013 and 12/31/2018. Receiver operating characteristic curve analysis determined NLR cutoffs for 1-year in-hospital, all-cause and cardiac-related mortality; major adverse cardiovascular events (MACEs); and major adverse limb events (MALEs).<h4>Results</h4>Among 195 patients (age, 74.0 years, SD: 11.5; 51.8% male; body mass index, 23.4 kg/m2, SD: 4.2), 14.4% exhibited acute limb ischemia. After 1 year, patients with NLR>8 had higher in-hospital mortality (21.1% vs. 3.6%, P<0.001), all-cause mortality (54.4% vs. 13.8%, P<0.001), cardiac-related mortality (28.1% vs. 6.5%, P<0.001), MACE (29.8% vs. 13.0%, P = 0.008), and MALE (28.1% vs. 13.0%, P = 0.021) rates than those with NLR<8. In multivariate logistic regression, NLR≥8 was significantly associated with all-cause (P<0.001) and cardiac-related (adjusted HR: 5.286, 95% CI: 2.075-13.47, P<0.001) mortality, and NLR≥6 was significantly associated with MALEs (adjusted HR: 2.804, 95% CI: 1.292-6.088, P = 0.009). Each increase in the NLR was associated with increases in all-cause (adjusted HR: 1.028, 95% CI: 1.008-1.049, P = 0.007) and cardiac-related (adjusted HR:1.027, 95% CI: 0.998-1.057, P = 0.073) mortality but not in-hospital mortality or MACEs.<h4>Conclusion</h4>CLI patients with high NLRs had significantly higher risks of 1-year all-cause and cardiac-related mortality and MALEs. The NLR can be used for prognostic prediction in these patients.
format	article
author	Min-I Su Cheng-Wei Liu
author_facet	Min-I Su Cheng-Wei Liu
author_sort	Min-I Su
title	Neutrophil-to-lymphocyte ratio associated with an increased risk of mortality in patients with critical limb ischemia.
title_short	Neutrophil-to-lymphocyte ratio associated with an increased risk of mortality in patients with critical limb ischemia.
title_full	Neutrophil-to-lymphocyte ratio associated with an increased risk of mortality in patients with critical limb ischemia.
title_fullStr	Neutrophil-to-lymphocyte ratio associated with an increased risk of mortality in patients with critical limb ischemia.
title_full_unstemmed	Neutrophil-to-lymphocyte ratio associated with an increased risk of mortality in patients with critical limb ischemia.
title_sort	neutrophil-to-lymphocyte ratio associated with an increased risk of mortality in patients with critical limb ischemia.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/15dfb4130b6d4813adebfa2620109fd0
work_keys_str_mv	AT minisu neutrophiltolymphocyteratioassociatedwithanincreasedriskofmortalityinpatientswithcriticallimbischemia AT chengweiliu neutrophiltolymphocyteratioassociatedwithanincreasedriskofmortalityinpatientswithcriticallimbischemia
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Neutrophil-to-lymphocyte ratio associated with an increased risk of mortality in patients with critical limb ischemia.

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