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The Role of Neutrophil-to-Lymphocyte Ratio in Predicting All-Cause Mortality and Survival Rates in Patients With Cor
1Department of Intensive Care Unit, Nanjing Lishui People's Hospital, 211200 Nanjing, Jiangsu, China.
Aims/Background:
Cor pulmonale is characterised by right ventricular hypertrophy and dysfunction due to chronic lung disease or pulmonary vascular disease. Mortality in patients with pulmonary heart disease is influenced by a variety of factors; therefore, elucidating prognostic factors is essential to improve patient management and therapeutic strategies. The neutrophil-to-lymphocyte ratio (NLR), a marker of systemic inflammation, has been implicated in cardiovascular and pulmonary diseases. This study aims to evaluate the prognostic value of NLR in assessing all-cause mortality and survival in patients with cor pulmonale.
Methods:
We conducted a retrospective analysis of data from 6681 patients in the Medical Information Mart for Intensive Care IV database, classifying them into low and high NLR groups based on the median NLR value of 8.26. Clinical indicators, including albumin levels, kidney function, and haematological results, were compared between groups. Multivariate models were used to assess the relationship between NLR and mortality risk. Subgroup analyses were conducted to validate findings across different populations.
Results:
The high-NLR group exhibited significantly lower albumin levels, poorer kidney function, and unfavourable haematological parameters. Patients aged ≥65 years and those with high-risk medical histories were more prevalent in the high-NLR group. Model analysis demonstrated that elevated NLR was independently associated with increased risk of adverse outcomes, with hazard ratios of 1.58, 1.37, and 1.22 across three adjusted models. A strong correlation was observed between NLR and all-cause mortality, with a nonlinear relationship indicating a complex impact on mortality risk. Subgroup analyses confirmed the consistency of these findings across various patient subgroups.
Conclusion:
NLR is a significant prognostic marker for all-cause mortality in patients with cor pulmonale. Routine assessment of NLR may aid clinicians in risk assessments to enhance prognosis and management strategies. Further research is needed to explore the clinical utility of NLR in this population.