Platelet-to-lymphocyte ratio as a predictive index for delirium in critically ill patients: A retrospective
Xuandong Jiang1, Yanfei Shen2, Qiang Fang3
1Intensive Care Unit, Dongyang People's Hospital, Dongyang.
Insights
A high platelet-to-lymphocyte ratio (PLR) may predict delirium in intensive care unit (ICU) patients. This simple blood test could help identify patients at risk for early intervention.
Area of Science:
- Critical Care Medicine
- Neuropsychiatry
- Inflammation Biomarkers
Background:
- Delirium is a common neuropsychiatric syndrome in critically ill patients.
- Systemic inflammation is a suspected underlying factor in delirium pathophysiology.
- The platelet-to-lymphocyte ratio (PLR) is an emerging inflammatory marker.
Purpose of the Study:
- To evaluate the predictive value of the platelet-to-lymphocyte ratio (PLR) for delirium development in the intensive care unit (ICU).
Main Methods:
- Retrospective analysis of clinical and laboratory data from 319 ICU patients.
- Utilized Locally Weighted Scatterplot Smoothing to identify a PLR threshold.
- Employed logistic regression to assess the association between PLR and delirium.
Main Results:
- Delirium occurred in 9.1% of patients.
- A PLR greater than 100 was an independent predictor of delirium (OR: 1.003, 95% CI: 1.001-1.005).
- Increased age and lower arterial oxygen/inspired oxygen fraction ratio also predicted delirium.
Conclusions:
- Elevated PLR on ICU admission is associated with a higher incidence of delirium.
- The easily calculable PLR may serve as a valuable predictive index for delirium in ICUs.
- Early identification of delirium risk via PLR can facilitate timely interventions.
Abstract:
Delirium is a neuropsychiatric syndrome commonly encountered in critically ill patients, and systemic inflammation has been strongly implicated to underlie its pathophysiology. This study aimed to investigate the predictive value of the platelet-to-lymphocyte ratio (PLR) for delirium in the intensive care unit (ICU).In this retrospective observational study, we analyzed the clinical and laboratory data of 319 ICU patients from October 2016 to December 2017. Using the Locally Weighted Scatterplot Smoothing technique, a PLR knot was detected at a value of approximately 100. Logistic regression was used to investigate the association between the PLR and delirium.Of the 319 patients included in this study, 29 (9.1%) were diagnosed with delirium. In the delirium group, the duration of mechanical ventilation was significantly longer than that in the no-delirium group (40.2 ± 65.5 vs. 19.9 ± 26.5 hours, respectively; P < .001). A multiple logistic regression analysis showed that PLR > 100 (odds ratio [OR]: 1.003, 95% confidence interval [CI]: 1.001-1.005), age (OR: 2.76, 95% CI: 1.110-6.861), and the ratio of arterial oxygen partial pressure to the inspired oxygen fraction (OR: 0.996, 95% CI: 0.992-0.999) were independent predictors of delirium.In our study, a high PLR value on ICU admission was associated with a higher incidence of delirium. Owing to easy calculability, the PLR could be a useful delirium predictive index in ICUs, thereby enabling early interventions to be implemented.