Neutrophil Percentage-to-Albumin Ratio: Unveiling a New Perspective on Mortality Risk in Intensive Care Unit Asthma...

Asthma remains a prevalent diagnosis among intensive care unit (ICU) admissions, frequently linked to worsened patient outcomes. Therefore, identifying simple and effective indicators to predict the mortality risk of asthma patients in the ICU is particularly important. Given the unmet need for mortality biomarkers in critical asthma, this study specifically examined neutrophil percentage-to-albumin ratio's (NPAR's) correlation with ICU and in-hospital death.

We selected 1191 eligible asthma patients from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) 3.0 database for analysis. This study applied a multivariate Cox regression model to explore the relationship between NPAR levels and the risk of mortality in the ICU and during hospitalization. Additionally, we used restricted cubic splines (RCSs) models to investigate the potential nonlinear dose-response relationship between NPAR levels and the risk of mortality in the ICU and during hospitalization.

Among the 1192 enrolled asthma cases, the cohort demonstrated a mean age of 58.1 ± 18.1 years, of which 38.7% were male. Asthma patients with higher NPAR faced substantially greater mortality risks during intensive care and hospitalization (hazard ratio [HR] range 1.75-2.14, p  < 0.01). The relationship between logarithmic transformation (ln) NPAR and ICU and in-hospital mortality rates is nonlinear. Threshold effect analysis showed that when the ln NPAR level exceeded 0.5, the risk of patient mortality significantly increased (HR range 1.574-1.831, p  < 0.05). Additionally, subgroup analysis revealed no significant interactions.

In ICU asthma patients, higher NPAR levels are associated with higher risks of ICU and in-hospital mortality, emphasizing the importance of these findings for early identification and timely intervention in reducing the mortality risk of ICU asthma patients.