Prognostic Value Of Neutrophil To Lymphocyte Ratio Combined With Uric Acid In Elderly Patients With Heart Failure

Objective To investigate the prognostic value of neutrophil to lymphocyte ratio(NLR)combined with serum uric acid(UA)level in elderly patients with heart failure.Methods A total of 113 patients over 80 years old with heart failure who were enrolled from Hebei General Hospital from January 1,2017 to December 31,2020 were retrospectively analyzed.The general clinical data,ultrasonic and laboratory data,and clinical medication data of the patients were collected.According to the prognosis,patients were divided into adverse event group and no adverse event group.Multivariate Logistic regression analysis was used to explore independent predictors of adverse events in elderly patients with heart failure,and ROC curve was drawn to evaluate the predictive value of NLR,UA and their combination on prognosis in elderly patients with heart failure.Results 1.Compared with the group without adverse events,the age of the adverse event group was higher,and the proportion of hypertensive patients,diastolic blood pressure and left ventricular ejection fraction(LVEF)were lower(P < 0.05).2.Compared with the group without adverse events,the distribution width of red blood cell volume(RDW),white blood cell count(WBC),neutrophil count,mean platelet volume(MPV),NLR and N-terminal-pro-B-type natriuretic peptide(NT-pro BNP)in the adverse event group were higher(P < 0.05).3.There was no statistical difference in drug use between the two groups.4.NLR,NT-pro BNP,and UA were included in the multivariate logistic regression equation,and the results showed that increased NLR increased the risk of heart failure with statistical significance[OR=1.238,95%CI(1.043～1.469),P=0.015].The higher the NT-pro BNP was,the higher the risk of heart failure was [OR=1.153,95%CI(1.046,1.271),P=0.004].The effect of uric acid on heart failure was not statistically significant [OR=0.999,95%CI(0.995～1.002),P=0.427].A ROC curve was used to analyze the predictive value of adverse events.The results showed that NLR [AUC:0.654,95%CI(0.545～0.764),P=0.007],the optimal cut-off value was 0.312,the sensitivity was 63.2%,and the specificity was 68%.UA[AUC: 0.565,95%CI(0.455～0.674),P=0.263],the optimal cut-off value was 0.206,the sensitivity was 57.9%,and the specificity was 62.7%.Combined predictor of UA and NLR [AUC: 0.661,95%CI(0.553～ 0.769),P=0.005],the optimal cut-off value was 0.298,the sensitivity was 71.1%,and the specificity was58.7%.Among the NT-pro BNP [AUC:0.683,95%CI(0.582～0.783),P=0.002],the optimal cut-off value was 0.335,the sensitivity was 89.5%,and the specificity was 44.0%.A ROC curve was used to compare the predictive values of NLR,UA,and their combined predictor for adverse events of heart failure.The results showed that there was no significant difference between the combined predictor and NLR and UA(P > 0.05).The combined predictor was significantly higher than that of NLR[95%CI(-0.010～0.023),Z=0.802,P=0.423].The combined predictors were compared with UA[95%CI(-0.029～0.222),Z=1.506,P=0.132].Conclusion NLR is an independent predictor of senile heart failure.NLR combined with UA may have predictive value for the prognosis of elderly patients with heart failure.NLR combined with uric acid couldn’t demonstrate predictive value over NLR or uric acid alone.