ArticleBMJ open2021
Neutrophil-to-lymphocyte ratio as a predictor of mortality in intensive care unit patients: a retrospective analysis of the Medical Information Mart for Intensive Care III Database.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Early Postoperative Inflammatory Indices Predict Long-Term Neuro-ICU Stay in Patients Requiring Prolonged Care After Supratentorial Brain Tumor Resection: Development and Validation of an Integrated Model.CNS neuroscience & therapeutics · 2026Article
- Plant-based enteral nutrition outperforms ultra-processed formulas in mitigating consequences of antibiotic-induced dysbiosis.JCI insight · 2026Article
- IMPACT OF LEUKOCYTE INFLAMMATORY MARKERS ON OUTCOMES OF CRITICALLY ILL PATIENTS WITH GASTROINTESTINAL DISEASES.Arquivos de gastroenterologia · 2026Article
- Complete blood count (CBC)-derived indices at admission and short-term outcomes in ICU patients: a retrospective study.Annals of medicine · 2025Article
- Changes in Hemogram-Derived Ratios in Patients with Sepsis Undergoing Cytokine-Filtered Continuous Renal Replacement Therapy in the Intensive Care Unit: A Retrospective Single-Center Study.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- Hematologic Ratios in Donkeys: Reference Intervals and Response to Experimentally Induced Endotoxemia.Animals : an open access journal from MDPI · 2025Article
- Differential impact of neutrophil-to-lymphocyte ratio and time-weighted NLR on mortality and survival in critically ill children: insights from a retrospective study.Frontiers in pediatrics · 2025Article
- Developing Augmented Pro-SOFA and Pro-SAPS Models by Integrating Biomarkers PCT, NLR, and CRP with SOFA and SAPS-III Scores.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Prognostic value of lymphocyte count for in-hospital mortality in patients with severe AECOPD.BMC pulmonary medicine · 2022Article
- High Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios Are Associated with a Higher Risk of Hemodialysis Vascular Access Failure.Biomedicines · 2022Article
- Association of the neutrophil-lymphocyte ratio with outcome in sick hospitalized neonatal foals.Journal of veterinary internal medicineArticle
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIdentifying high-risk patients in the intensive care unit (ICU) is important given the high mortality rate. However, existing scoring systems lack easily accessible, low-cost and effective inflammatory markers. We aimed to identify inflammatory markers in routine blood tests to predict mortality in ICU patients and evaluate their predictive power.
designRetrospective case-control study.
settingSingle secondary care centre.
participantsWe analysed data from the Medical Information Mart for Intensive Care III database. A total of 21 822 ICU patients were enrolled and divided into survival and death groups based on in-hospital mortality. PRIMARY AND SECONDARY OUTCOME MEASURES: The predictive values of potential inflammatory markers were evaluated and compared using receiver operating characteristic curve analysis. After identifying the neutrophil-to-lymphocyte ratio (NLR) as having the best predictive ability, patients were redivided into low (≤1), medium (1-6) and high (>6) NLR groups. Univariate and multivariate logistic regression analyses were performed to evaluate the association between the NLR and mortality. The area under the curve (AUC), net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to assess whether incorporating the NLR could improve the predictive power of existing scoring systems.
resultsThe NLR had the best predictive ability (AUC: 0.609; p<0.001). In-hospital mortality rates were significantly higher in the low (OR (OR): 2.09; 95% CI 1.64 to 2.66) and high (OR 1.64; 95% CI 1.50 to 1.80) NLR groups than in the medium NLR group. Adding the NLR to the Simplified Acute Physiology Score II improved the AUC from 0.789 to 0.798, with an NRI and IDI of 16.64% and 0.27%, respectively.
conclusionsThe NLR predicted mortality in ICU patients well. Both low and high NLRs were associated with elevated mortality rates, including the NLR may improve the predictive power of the Simplified Acute Physiology Score II.
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