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DECREASE IN THE PLATELET-TO-LYMPHOCYTE RATIO IN DAYS AFTER ADMISSION FOR SEPSIS CORRELATES WITH IN-HOSPITAL

Rui Zheng1, Yi-Yi Shi2, Jing-Ye Pan

  • 1Department of Critical Care Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Shock (Augusta, Ga.)
|February 21, 2023
PubMed
Summary

The platelet-to-lymphocyte ratio (PLR) shows a U-shaped relationship with sepsis mortality. An early decrease in PLR correlates with increased in-hospital mortality, highlighting its prognostic value in sepsis patients.

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Area of Science:

  • Critical Care Medicine
  • Hematology
  • Biomarkers

Background:

  • Previous studies indicate a link between elevated platelet-to-lymphocyte ratio (PLR) and poor prognosis.
  • The prognostic significance of early changes in PLR for sepsis patients remains unclear.

Purpose of the Study:

  • To investigate the relationship between baseline PLR, its longitudinal changes, and in-hospital mortality in sepsis patients.
  • To determine if early alterations in PLR predict outcomes in sepsis.

Main Methods:

  • Retrospective cohort analysis of 3,303 patients meeting Sepsis-3 criteria using the MIMIC-IV database.
  • Calculation of PLR from platelet and lymphocyte counts, with measurements collected within 3 days of admission.
  • Analysis of baseline PLR and in-hospital mortality using multivariable logistic regression and longitudinal PLR trends with generalized additive mixed models.

Main Results:

  • A U-shaped association was observed between baseline PLR and in-hospital mortality; both low and high PLR tertiles were linked to increased mortality.
  • Nonsurvivors exhibited a faster decline in PLR compared to survivors within 3 days of ICU admission.
  • The daily difference in PLR change between nonsurvivors and survivors, after confounder adjustment, showed a significant trend.

Conclusions:

  • A U-shaped relationship exists between baseline PLR and in-hospital mortality in sepsis.
  • Significant differences in PLR dynamics over time were observed between sepsis survivors and nonsurvivors.
  • An early decrease in PLR is associated with increased in-hospital mortality, suggesting its utility as an early prognostic marker in sepsis.