Plasma Neutrophil-to-Lymphocyte Ratio on the Third Day Postburn is Associated with 90-Day Mortality Among Patients with Burns Over 30% of Total Body Surface Area in Two Chinese Burns Centers

Figures & data

Table 1 Baseline Characteristics Comparing Severe Burn Survivors and Non-Survivors

	Survivor	Non Survivor	P
Number of patients	522 (90.5%)	55 (9.5%)
Age (years)	43.58±15.11	52.55±17.98	<0.001
Sex (%)			0.875
Male	384 (73.6)	41 (74.5)
Female	138 (26.4)	14 (25.5)
Inhalation injury			<0.001
Yes	131 (25.1)	34 (61.8)
No	391 (74.9)	21 (38.2)
Mechanical ventilation			<0.001
Yes	92 (17.6)	37 (67.3)
No	430 (82.4)	18 (32.7)
Surgery during the first week			0.132
Yes	302 (57.9)	26 (47.3)
No	220 (42.1)	29 (52.7)
%TBSA burned	49.59±17.94	67.49±25.07	<0.001
BI	33.46±17.30	52.58±25.99	<0.001

Note: Data were presented as mean ± SD, or number (%).

Abbreviations: BI, burn index; TBSA, total body surface area.

Table 2 Laboratory Parameters Comparing Severe Burn Survivors and Non-Survivors

	Day 1		P	Day 3		P	Day 7		P
	Survivor	Non Survivor		Survivor	Non Survivor		Survivor	Non Survivor
WBC (x10^9/L)	18.92±8.06	22.05±9.10	0.07	11.57±5.33	12.70±9.33	0.383	13.77±6.35	13.83±8.85	0.960
Neutrophils (*10^9/L)	16.33±7.39	19.11±8.12	0.009	9.58±4.83	10.93±8.50	0.252	11.49±5.86	11.78±7.93	0.725
Lymphocytes (*10^9/L)	1.43±1.04	1.66±1.36	0.226	1.10±0.56	0.91±0.40	0.017	1.27±0.82	1.19±0.75	0.448
NLR	14.45±9.46	15.30±7.99	0.517	9.58±5.22	12.21±6.11	0.001	10.55±7.45	11.62±6.61	0.305
RBC (x10^12/L)	5.05±0.91	5.21±1.08	0.245	4.30±0.81	4.13±0.88	0.147	3.51±0.64	3.08±0.58	<0.001
Hemoglobin (g/L)	154.53±29.04	159.92±32.88	0.197	130.62±26.25	125.95±27.90	0.213	105.97±20.48	93.56±17.22	<0.001
PLT (x10^9/L)	188.68±77.47	176.14±91.15	0.263	132.73±70.95	93.45±85.50	<0.001	207.42±93.66	137.99±75.96	<0.001

Abbreviations: WBC, white blood cell count; NLR, neutrophils/lymphocytes; RBC, red blood cell count; PLT, platelet count.

Figure 1 Receiver operating characteristic (ROC) curve analysis of preoperative neutrophil-to-lymphocyte ratio for the 90-day mortality in severely burned patients.

Table 3 Logistic Regression for the Later Postburn Period Mortality

	β	SE	Wald	P	OR	95% CI
Age	−0.050	0.011	19.391	<0.001	0.951	0.930	0.972
Inhalation injury	−0.724	0.372	3.790	0.052	2.062	0.995	4.272
Mechanical ventilation	1.506	0.382	15.562	<0.001	4.507	2.133	9.524
%TBSA	0.006	0.019	0.091	0.764	1.006	0.970	1.043
BI	−0.032	0.009	13.700	<0.001	0.969	0.952	0.985
Day 1
WBC (x10^9/L)	−0.022	0.130	0.029	0.864	0.978	0.758	1.262
Neutrophils (x10^9/L)	0.013	0.145	0.008	0.927	1.013	0.763	1.346
Day3
Lymphocyte (x10^9/L)	0.442	0.456	0.943	0.332	1.557	0.637	3.802
NLR	−0.068	0.025	7.234	0.007	0.934	0.889	0.982
PLT (x10^9/L)	−0.001	0.003	0.061	0.806	0.999	0.993	1.005
Day 7
RBC (x10^12/L)	0.182	0.906	0.041	0.840	1.200	0.203	7.089
Hemoglobin (g/L)	0.011	0.029	0.153	0.696	1.011	0.955	1.071
PLT (x10^9/L)	0.007	0.003	7.274	0.007	1.007	1.002	1.012

Abbreviations: TBSA, total body surface area; BI, burn index; CI, confidence interval; WBC, white blood cell count; RBC, red blood cell count; PLT platelet count.

Figure 2 Kaplan–Meier curve of 90-day survival of severe burn injuries. The blue line indicates patients’ survival in the 3rd NLR ≤ 10.50 group. The green line indicates patient’ survival in the 3rd NLR >10.50 group.