TY  - JOUR
PY  - 2018//
TI  - Predictive value of neutrophil-to-lymphocyte ratio in 30-day mortality of patients with acute paraquat poisoning
JO  - Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi
A1  - Liang, H.
A1  - Gao, Y.
A1  - Liu, Y.
A1  - Gu, S. S.
A1  - Cai, N.
A1  - Jiang, M.
A1  - Wang, J.
A1  - He, F.
SP  - 911
EP  - 914
VL  - 36
IS  - 12
N2  - <b>Objective:</b> To investigate the predictive value of neutrophil-to-lymphocyte Ratio (NLR) in 30-day mortality of patients with acute paraquat poisoning. <b>Methods:</b> We respectively reviewed the clinical parameters of 115 patients with acute paraquat poisoning. They were divided into survival (<i>n</i>=64) and non-survival (<i>n</i>=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. <b>Results:</b> 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 (<i>OR</i> 1.477, 95%<i>CI</i> 1.035-2.107, <i>P</i><0.05). The NLR to predict the death of the area under the ROC curve was 0.894 (95%<i>CI</i>: 0.8212-0.9663, <i>P</i><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; <i>P</i><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 <i>vs</i>. 6.19±2.54, <i>P</i><0.05). <b>Conclusion:</b> 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.<p />  <p>Language: zh</p>  <b>目的：</b> 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。 <b>方法：</b> 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。 <b>结果：</b> 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（<i>OR</i>:1.477，95%<i>CI</i>: 1.035~2.107，<i>P</i><0.05）。NLR预测效能的ROC曲线下面积为0.894（95%<i>CI</i>:0.821 2~0.966 3，<i>P</i><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（<i>r</i>=0.525, <i>P</i><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（<i>P</i><0.05）。 <b>结论：</b> 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。.<p />  <p>Language: zh</p>
LA  - zh
SN  - 1001-9391
UR  - http://dx.doi.org/10.3760/cma.j.issn.1001-9391.2018.12.007
ID  - ref1
ER  -