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IMPACT OF LEUKOCYTE INFLAMMATORY MARKERS ON OUTCOMES OF CRITICALLY ILL PATIENTS WITH GASTROINTESTINAL DISEASES
Anna Clara Rios Rocha1, Liana Codes1,2, Fernanda Sales1,2
1Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil.
Background:
Leukocyte markers, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune inflammation index (SII), are related to systemic inflammation and may predict organ failure (OF) and mortality in critically ill patients. This study aims to evaluate the association of NLR, MLR, and SII with OF and mortality in medical and surgical patients admitted to a specialty ICU dedicated to the treatment of gastrointestinal (GI) disorders.
Methods:
All patients admitted to a specialty GI ICU in Brazil, from January 2016 to December 2023, were retrospectively evaluated. Baseline white blood cell counts, NLR, MLR, and SII were calculated in all subjects and compared to different outcomes, including OF and in-hospital mortality.
Results:
6,703 patients (3,593 women, mean age 67.4 ± 18.3 years) were included in the study. NLR, MLR, and SII were significantly higher in subjects with sepsis and circulatory failure (CF). Likewise, higher NLR and SII were also observed in patients with kidney (KF) and respiratory (RF) failure. NLR, MLR and SII were associated with in-hospital mortality, but only NLR was independently associated with CF (OR: 1.017; 95%CI: 1.013-1.021; P<0.0001), RF (OR: 1.007; 95%CI: 1.001-1.012; P<0.0001) and with an increased risk of death (OR: 1.016; 95%CI: 1.012-1.019; P<0.0001) in multivariate analysis.
Conclusion:
Leukocyte markers, particularly NLR and MLR, were associated with OF and mortality in critically ill patients with gastrointestinal disorders, but only NLR was independently associated with CF, RF, and mortality.
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