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[Correlation between Neutrophil-to-Lymphocyte Ratio, High-Sensitivity C-Reactive Protein, and Transfusion-Related
Jia Li1, Jun Yang2, Hui Jiang2
1Department of Blood Transfusion, The Second People's Hospital of Liangshan Yi Autonomous Prefecture, Xichang 615000, Sichuan Province, China.
Objective:
To investigate the correlation between the neutrophil-to-lymphocyte ratio (NLR), high-sensitivity C-reactive protein (hs-CRP), and transfusion-related adverse reactions.
Methods:
Patients who received transfusion therapy (including plasma, red blood cells, platelets, and cryoprecipitate) at our hospital from May 2020 to December 2024 were enrolled. Among them, 55 patients who experienced transfusion-related adverse reactions were included in the observation group. According to a 1∶2 matching ratio, 110 patients from the same (or nearby) departments during the same period who received the same blood products but did not experience transfusion-related adverse reactions were selected as the control group. General clinical data, complete blood count parameters, and hs-CRP levels were compared between the two groups. Univariate and multivariate logistic regression analyses were used to identify risk factors for transfusion-related adverse reactions and construct a logistic regression prediction model. Receiver operating characteristic (ROC) curves were constructed, and the area under the curve (AUC) was calculated to evaluate the predictive efficacy of individual and combined risk factors.
Results:
The differences in white blood cell (WBC), neutrophil (Neu), monocyte (Mon), neutrophil-to-lymphocyte ratio (NLR), neutrophil-monocyte ratio (NMR), high-sensitivty C-reactive protein (hs-CRP), lymphocyte-monocyte ratio (LMR) between the observation group and the control group were statistically significant (P<0.05), while no statistically significant differences were observed among the other indicators (P>0.05). Logistic regression analysis showed that NLR(OR=1.220, 95%CI:1.064-1.398) and hs-CRP(OR=1.056, 95%CI:1.035-1.076） were independent risk factors for transfusion-related adverse reactions. ROC curve analysis demonstrated that the AUC for predicting transfusion-related adverse reactions using NLR, hs-CRP, and their combination were 0.827, 0.891, and 0.924, respectively. The corresponding sensitivities were 78.0%, 80.0%, and 81.8%, and the specificities were 75.5%, 85.5%, and 89.1%, respectively.
Conclusion:
Elevated NLR and hs-CRP levels are associated with a higher risk of transfusion-related adverse reactions, and their combination shows superior predictive value.
