Platelet to lymphocyte ratio: can it be an early economical mortality predictor of AKI patients?
Abstract Background Acute kidney injury (AKI) affects over 13 million individuals annually worldwide, resulting in 1.7 million deaths. The potential long-term progression to chronic kidney disease (CKD) and renal failure, as well as the acute use of health care resources associated with acute kidney...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2024-01-01
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| Series: | The Egyptian Journal of Internal Medicine |
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| Online Access: | https://doi.org/10.1186/s43162-023-00267-4 |
| _version_ | 1797362848789168128 |
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| author | Arnab Purkayastha Amit Kalwar Zakia Firdaus Bhaskar Kanti Nath Prithwiraj Bhattacharjee |
| author_facet | Arnab Purkayastha Amit Kalwar Zakia Firdaus Bhaskar Kanti Nath Prithwiraj Bhattacharjee |
| author_sort | Arnab Purkayastha |
| collection | DOAJ |
| description | Abstract Background Acute kidney injury (AKI) affects over 13 million individuals annually worldwide, resulting in 1.7 million deaths. The potential long-term progression to chronic kidney disease (CKD) and renal failure, as well as the acute use of health care resources associated with acute kidney injury (AKI), impose enormous costs on society. The platelet-to-lymphocyte ratio (PLR) has emerged as a useful economical marker for detecting changes in platelet and lymphocyte counts owing to acute inflammatory and prothrombotic states. This study aimed to determine the PLR in patients with AKI and evaluate the in-hospital mortality. Results The median PLR was compared between the non-survivor and survivor groups, and it was determined that the non-survivor group had a significantly higher PLR. ( p < 0.001) For further subgroup analysis, the PLR was stratified into three groups: ≤ 100, 101–200, and > 200. Significantly more patients were demised in the PLR group 101–200 than in the PLR group ≤ 100, while all of the patients died in the PLR group greater than 200. The group with a PLR > 200 had a higher SOFA score > 10 (p = 0.006), a lower eGFR (p = 0.001), and higher platelet counts (p = 0.001), higher serum creatinine (p = 0.001), BUN (p < 0.001), and procalcitonin levels (p = 0.007). In multivariate Logistic regression analysis to predict the mortality outcome, PLR (OR 1.051; 95% CI, 1.016–1.087; p = 0.004) was identified as one of the significant indicators predicting AKI mortality. Other statistically significant indicators included SOFA scores (OR 2.789; 95% CI, 1.478–5.260; p = 0.002), procalcitonin levels (OR 0.898; 95% CI, 0.818–0.987; p = 0.025), and duration of hospital stay (OR 0.494; 95% CI, 0.276–0.886; p = 0.017). The ROC curve for the PLR yielded a value of 0.803 [95% CI, 0.720–0.886; p < 0.001] with the optimal cutoff value for the PLR to determine prognosis being 107.905, with a sensitivity of 82.5% and a specificity of 51.2%. Conclusion PLR plays a significant role in the early prediction of prognosis (survival or death) for patients with AKI in ICU on a short-term basis. |
| first_indexed | 2024-03-08T16:13:19Z |
| format | Article |
| id | doaj.art-645cf40d89da415b848939f6a4e7bb1b |
| institution | Directory Open Access Journal |
| issn | 2090-9098 |
| language | English |
| last_indexed | 2024-03-08T16:13:19Z |
| publishDate | 2024-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Internal Medicine |
| spelling | doaj.art-645cf40d89da415b848939f6a4e7bb1b2024-01-07T12:47:53ZengSpringerOpenThe Egyptian Journal of Internal Medicine2090-90982024-01-013611710.1186/s43162-023-00267-4Platelet to lymphocyte ratio: can it be an early economical mortality predictor of AKI patients?Arnab Purkayastha0Amit Kalwar1Zakia Firdaus2Bhaskar Kanti Nath3Prithwiraj Bhattacharjee4Department of Medicine, Silchar Medical College & HospitalJeevan Jyoti Institue of Medical SciencesDepartment of Medicine, Silchar Medical College & HospitalDepartment of Medicine, Dhubri Medical College & HospitalDepartment of Medicine, Silchar Medical College and HospitalAbstract Background Acute kidney injury (AKI) affects over 13 million individuals annually worldwide, resulting in 1.7 million deaths. The potential long-term progression to chronic kidney disease (CKD) and renal failure, as well as the acute use of health care resources associated with acute kidney injury (AKI), impose enormous costs on society. The platelet-to-lymphocyte ratio (PLR) has emerged as a useful economical marker for detecting changes in platelet and lymphocyte counts owing to acute inflammatory and prothrombotic states. This study aimed to determine the PLR in patients with AKI and evaluate the in-hospital mortality. Results The median PLR was compared between the non-survivor and survivor groups, and it was determined that the non-survivor group had a significantly higher PLR. ( p < 0.001) For further subgroup analysis, the PLR was stratified into three groups: ≤ 100, 101–200, and > 200. Significantly more patients were demised in the PLR group 101–200 than in the PLR group ≤ 100, while all of the patients died in the PLR group greater than 200. The group with a PLR > 200 had a higher SOFA score > 10 (p = 0.006), a lower eGFR (p = 0.001), and higher platelet counts (p = 0.001), higher serum creatinine (p = 0.001), BUN (p < 0.001), and procalcitonin levels (p = 0.007). In multivariate Logistic regression analysis to predict the mortality outcome, PLR (OR 1.051; 95% CI, 1.016–1.087; p = 0.004) was identified as one of the significant indicators predicting AKI mortality. Other statistically significant indicators included SOFA scores (OR 2.789; 95% CI, 1.478–5.260; p = 0.002), procalcitonin levels (OR 0.898; 95% CI, 0.818–0.987; p = 0.025), and duration of hospital stay (OR 0.494; 95% CI, 0.276–0.886; p = 0.017). The ROC curve for the PLR yielded a value of 0.803 [95% CI, 0.720–0.886; p < 0.001] with the optimal cutoff value for the PLR to determine prognosis being 107.905, with a sensitivity of 82.5% and a specificity of 51.2%. Conclusion PLR plays a significant role in the early prediction of prognosis (survival or death) for patients with AKI in ICU on a short-term basis.https://doi.org/10.1186/s43162-023-00267-4PLRAKIICUSOFA score |
| spellingShingle | Arnab Purkayastha Amit Kalwar Zakia Firdaus Bhaskar Kanti Nath Prithwiraj Bhattacharjee Platelet to lymphocyte ratio: can it be an early economical mortality predictor of AKI patients? The Egyptian Journal of Internal Medicine PLR AKI ICU SOFA score |
| title | Platelet to lymphocyte ratio: can it be an early economical mortality predictor of AKI patients? |
| title_full | Platelet to lymphocyte ratio: can it be an early economical mortality predictor of AKI patients? |
| title_fullStr | Platelet to lymphocyte ratio: can it be an early economical mortality predictor of AKI patients? |
| title_full_unstemmed | Platelet to lymphocyte ratio: can it be an early economical mortality predictor of AKI patients? |
| title_short | Platelet to lymphocyte ratio: can it be an early economical mortality predictor of AKI patients? |
| title_sort | platelet to lymphocyte ratio can it be an early economical mortality predictor of aki patients |
| topic | PLR AKI ICU SOFA score |
| url | https://doi.org/10.1186/s43162-023-00267-4 |
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