High platelet-lymphocyte ratio is a risk factor for 30-day mortality in in-hospital cardiac arrest patients: a case-control study

ABSTRACT

Objectives

This study explored the association of early dynamic changes in inflammatory markers with 30-day mortality in in-hospital cardiac arrest (IHCA) patients.

Methods

This study retrospectively enrolled 85 IHCA patients. The outcome was 30-day mortality. A linear mixed model was used to analyze the dynamic changes in laboratory indicators within 72 h after recovery of spontaneous circulation(ROSC).

Results

Within 72 h after ROSC, the absolute monocyte count (AMC) showed no significant change trend, and the absolute lymphocyte count (ALC) showed an overall upward trend, while the absolute neutral count (ANC), white blood cell (WBC) count, platelet (PLT) count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) showed overall downward trends. Cox multivariate analysis showed that the Charlson comorbidity index (CCI) (HR = 2.37, 95%CI (1.08, 5.17)), Acute Physiology and Chronic Health Evaluation II (APACHE II) score (HR = 2.55, 95% CI (1.00, 6.50)), abnormal creatinine level before IHCA (HR = 3.42, 95% CI (1.44, 8.10)) and PLR within 72 h after ROSC (HR = 2.99, 95% CI (1.44, 6.21)) were independent risk factors for 30-day mortality.

Conclusions

The PLR can be used as a predictor of 30-day mortality in IHCA patients.

KEYWORDS:

• Cardiac arrest
• critical care
• mortality
• post-cardiac arrest syndrome
• ROSC

List of abbreviations

APACHE II =	=	Acute Physiology and Chronic Health Evaluation II;
ALC=	=	absolute lymphocyte count;
AMC=	=	absolute monocyte count;
ANC=	=	absolute neutrophil count;
CCI=	=	Charlson comorbidity index;
CI=	=	confidence interval;
CPR=	=	cardiopulmonary resuscitation;
GCS=	=	Glasgow Coma Scale;
HR=	=	hazard ratio;
IHCA=	=	in-hospital cardiac arrest;
NLR=	=	neutrophil-lymphocyte ratio;
OHCA=	=	out-of-hospital cardiac arrest;
PLR=	=	platelet-lymphocyte ratio;
PLT=	=	platelet;
ROSC=	=	recovery of spontaneous circulation;
WBC=	=	white blood cell;
SII=	=	systemic immune-inflammation index.

Acknowledgments

We thank all of the patients in this study for their cooperation.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed.

Author contributions

F Li and L Huang designed the study and performed the experiments; J Peng and X Wang analyzed the data; L Huang wrote the manuscript; F Li reviewed and edited the manuscript. All authors read and approved the final manuscript, and all authors agreed to be accountable for all aspects of the work.

Ethical approval and consent to participate

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent for publication

All the coauthors have approved this version of the manuscript and consent to publication.

Availability of data and materials

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This study was sponsored by The National Natural Science Foundation of China (number: 81801296).