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Citation |
Liang H, Gao Y, Liu Y, Gu SS, Cai N, Jiang M, Wang J, He F. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2018; 36(12): 911-914. |
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Affiliation |
Emergency Medical Department, the First Affiliated Hospital of Xi'An Jiao Tong University, XiAn 710061, China. |
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Copyright |
(Copyright © 2018, Tianjin shi lao dong wei sheng yan jiu suo) |
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DOI |
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PMID |
30812077 |
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Abstract |
Objective: To investigate the predictive value of neutrophil-to-lymphocyte Ratio (NLR) in 30-day mortality of patients with acute paraquat poisoning. Methods: We respectively reviewed the clinical parameters of 115 patients with acute paraquat poisoning. They were divided into survival (n=64) and non-survival (n=51) groups based on their 30-day outcome. Multivariate logistic regression was performed to identify risk factors of 30-day mortality. Receiver operating curve (ROC) test was applied to analysis to the predictive value of NLR in 30-day mortality ofacute paraquat poisoning patients. The correlations between NLR and severity index of paraquat poisoning (SIPP) were analyzed using Spearman's rank correlation coefficient. Results: Of the 115patients included in the study, 54 (46.96%) patients were males and 61 (53.04%) were females with a mean age of 38.96±13.58 years. The total mortality in 30-day was 44.35% (51/115). The NLR at admission was an independently risk factor of 30-day mortality of patients with acute paraquat poisoning (OR 1.477, 95%CI 1.035-2.107, P<0.05). The NLR to predict the death of the area under the ROC curve was 0.894 (95%CI: 0.8212-0.9663, P<0.01) ; the optimal cutoff threshold was 11.71; the sensitivity was 71.79% and the specificity was 94.29%; the positive predictive value was 93.33%and negative predictive value of 75.00%. Meanwhile, the positive likelihood ratio was 12.57 and the negative likelihood ratio was 0.30. The NLR was significantly associated with SIPP (Spearman rho 0.525; P<0.01) and it was significantly higher in patients with SIPP of ten or higher than in those with an SIPP less than 10 (15.02±12.40 vs. 6.19±2.54, P<0.05). Conclusion: The increased NLR at admission was an independently risk factor of 30-day mortality of patients with acute paraquat poisoning and it was significantly correlated with SIPP score. Therefore, NLR was useful for predicting prognosis of patients with acute paraquat poisoning. Language: zh 目的： 评估血中性粒细胞/淋巴细胞比率（Neutrophil-to-Lymphocyte Ratio，NLR）对急性百草枯中毒患者30 d死亡风险的预测价值。 方法： 回顾性分析收住南京大学医学院附属鼓楼医院急诊科的115例急性百草枯中毒患者临床资料，以中毒30 d后的临床转归情况分为存活组（64例）和死亡组（51例）。单因素及多因素logistic回归分析临床资料确定中毒患者死亡的高危因素。利用受试者工作特征曲线（receiver operating characteristic curve，ROC）评估NLR对中毒患者30 d死亡风险的预测价值。Spearman分析探讨NLR与百草枯中毒严重程度指数（severity index of paraquat poisoning，SIPP）之间的相关性。 结果： 急性百草枯中毒患者平均年龄（38.9±13.6）岁，男性54例，女性61例，总体病死率44.35%（51/115）。多因素Logistic回归分析显示，NLR是中毒患者死亡的危险因素（OR:1.477，95%CI: 1.035~2.107，P<0.05）。NLR预测效能的ROC曲线下面积为0.894（95%CI:0.821 2~0.966 3，P<0.01），最佳截断值为11.71（敏感度71.79%、特异度94.29%；阳性预测值93.33%、阴性预测值75.00%；阳性似然比12.57、阴性似然比0.30）。NLR与SIPP呈中等强度正相关（r=0.525, P<0.01），且SIPP≥10组患者NLR值（15.02±12.40）较SIPP<10组（6.19±2.54）均明显升高，差异有统计学意义（P<0.05）。 结论： NLR值增高是急性百草枯中毒患者死亡的高危因素，其与SIPP具有良好的相关性，对中毒患者的30 d死亡风险具有良好的预测价值。. Language: zh |
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Keywords |
Mortality; Neutrophil-to-Lymphocyte Ratio; Paraquat; Poisoning; Predictive value |