To Investigate The Clinical Value Of Platelet To Lymphocyte Ratio (PLR) In Predicting The Prognosis Of ICU Patients With Sepsis

Objective:To investigate the value of platelet-to-lymphocyte ratio(PLR)in predicting28-day mortality in ICU patients with sepsis.Methods: The clinical data of patients with sepsis admitted to intensive care Unit(ICU)of our Hospital from January 2018 to March 2021 were retrospectively analyzed,including gender,age,routine blood test,sequential organ failure assessment(SOFA)score,blood lactic acid(Lac)and procalcitonin(PCT)levels on admission and 48 hours after treatment.The prognosis was determined according to whether the patients survived or not.PLR was calculated according to the first blood routine after admission,and the patients were divided into low PLR group(PLR≤135)and medium PLR group(135<PLR<245);The incidence of acute kidney injury(AKI)and 28-day mortality in each group were compared.Pearson correlation analysis was used to analyze the correlation of PLR,PLR after 48 hours of treatment with SOFA score and blood Lac.The first blood routine of the patients was collected after admission,and PLR was calculated.Multivariate logistic regression was used to analyze the influencing factors of 28-day mortality in patients with sepsis,and ROC curve was used to determine the value of each indicator in the prognosis of patients with sepsis.Results:The SOFA scores(scores)of the three groups with low,medium and high PLR were 7.1 ± 3.7.6,7.3 ± 2.5 and 8.6 ± 2.5,respectively,Blood Lac(mmol/L)was 3.2 ±2.5,3.0 ± 2.1,4.8 ± 5.2,respectively,Patients had higher SOFA scores and blood Lac in the high PLR group than the low PLR and middle PLR groups,Statistically significant difference(all P <0.05),Although the three group values of procalcitonin and C-reactive protein were higher,However,the difference was not statistically significant(P> 0.05),The 28 d mortality rates in the three groups with low,medium and high PLR were 42.9%,17.8% and 68.9%,respectively,The high PLR group was significantly higher than the other two groups,Statistically significant difference(P <0.05),The incidence of AKI in each group was 42.9%,17.9%,and 47.3%,respectively,ICU stay were 8.5 ± 1.7,12.6 ± 3.2,18.1 ± 2.0 days,respectively,The cost of ICU admission is 72± 22,000 yuan,112 ± 21,000 yuan,134 ± 18,000 yuan respectively,The high PLR group was significantly higher than the other two groups,The differences were all statistically significant(all P <0.05),There was no correlation between PLR and blood Lac on admission(r=0.135,P>0.05),Was positively associated with the SOFA score(r=0.025,P<0.05),Treatment 48 h PLR was inversely associated with blood Lac(r=-0.701.p <0.05),A positive correlation with the SOFA score(r=0.015,P<0.05).Multiple logistic regression analysis showed that blood Lac,SOFA score,PLR,and 48 h PLR were the influencing factors for predicting 28 d mortality in ICU sepsis patients.PLR,48 h PLR were 0.649,0.670,0.730,and 0.787 respectively.The area under the ROC curve indicates that SOFA score was the best indicator of 28 d mortality in sepsis patients,and 48 h PLR was better than PLR at enrollment.Conclusions :High PLR has great clinical significance in predicting high 28-day mortality of ICU sepsis patients.PLR at 48 hours is better than PLR at admission,and dynamic monitoring of PLR is more meaningful,Patients with high PLR are more prone to AKI,while ICU stay may be longer and may be more costly.