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Updated: Jun 19, 2025
A Data-Driven Approach to Quantifying Immune States in Sepsis
Published on: February 7, 2025
Effect of lymphocyte-to-monocyte ratio on survival in septic patients: an observational cohort study
Xiang Hu1, Xiaoyi Qin2, Xiaolong Gu3
1Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Introduction:
The purpose of the present study was to evaluate the potential relationship of lymphocyte-to-monocyte ratio (LMR) with outcomes of septic patients at intensive care unit (ICU) admission.
Material And Methods:
3087 septic patients were included in the final cohort by using the Medical Information Mart for Intensive Care (MIMIC) database. We evaluated the association of different groups of LMRmax with 28-day survival and 1-year survival via Kaplan-Meier (K-M) analysis and Cox regression analysis. Subgroups analysis of LMRmax was performed to further explore the effect of LMRmax on survival.
Results:
According to the optimal cut-off value, the cohort was divided into low-LMRmax and high-LMRmax groups. The 28-day and 1-year survival rates were 47.9% and 19.9%, respectively, in the low-LMRmax group, and 60.4% and 25.9%, respectively, in the high-LMRmax group. Univariate logistic regression and K-M analyses revealed that the 28-day and 1-year survival rates of the high-LMRmax group were higher than those of the low-LMRmax group (both p < 0.001). A subgroup analysis of LMRmax identified a significant stepwise decrease in the risk of death at 28 days and 1 year from group 1 to group 4 (LMRmax increased gradually) after adjustment for multiple variables.
Conclusions:
We report for the first time that a lower LMRmax value is independently predictive of a poor prognosis in septic patients. Therefore, as an inexpensive and readily available indicator, LMRmax may facilitate stratification of prognosis in septic patients.
Insights
A lower maximum lymphocyte-to-monocyte ratio (LMRmax) predicts worse outcomes in intensive care unit (ICU) septic patients. Higher LMRmax levels are associated with significantly improved 28-day and 1-year survival rates.
Area of Science:
- Critical Care Medicine
- Hematology
- Prognostic Biomarkers
Background:
- Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
- Identifying reliable prognostic markers in septic patients admitted to the ICU is crucial for timely intervention and improved outcomes.
- The lymphocyte-to-monocyte ratio (LMR) has emerged as a potential biomarker in various inflammatory conditions.
Purpose of the Study:
- To investigate the association between the maximum lymphocyte-to-monocyte ratio (LMRmax) and patient outcomes in the intensive care unit (ICU).
- To determine if LMRmax can serve as an independent predictor of short-term (28-day) and long-term (1-year) survival in septic patients.
Main Methods:
- Analysis of 3087 septic patients from the Medical Information Mart for Intensive Care (MIMIC) database.
- Evaluation of LMRmax groups using Kaplan-Meier analysis and Cox regression.
- Subgroup analysis to explore the dose-response relationship between LMRmax and survival.
Main Results:
- Patients were categorized into low-LMRmax and high-LMRmax groups based on optimal cut-off values.
- The high-LMRmax group demonstrated significantly higher 28-day (60.4% vs 47.9%) and 1-year (25.9% vs 19.9%) survival rates compared to the low-LMRmax group (p < 0.001).
- A stepwise decrease in mortality risk was observed with increasing LMRmax levels across four subgroups, even after adjusting for multiple variables.
Conclusions:
- Lower LMRmax values are independently predictive of poor prognosis in ICU septic patients.
- LMRmax serves as an accessible and cost-effective indicator for prognostic stratification in sepsis.
- This study highlights the clinical utility of LMRmax in managing septic patients.
