PLR predicts in-hospital mortality in CICU patients

The platelet-to-lymphocyte ratio (PLR) might be a potential indicator of in-hospital mortality in patients admitted to the cardiac intensive care unit (CICU), a recent study has found.

The study included 5,577 CICU patients who were divided into PLR quartiles: Q1 (PLR <104.8; n=1,392), Q2 (104.8≤ PLR <167.0; n=1,399), Q3 (167.0≤ PLR <271.0; n=1,392), and Q4 (PLR ≥271.0; n=1,394). Patients in higher PLR quartiles tended to have more comorbidities and were older, had male predominance, and higher body mass index than counterparts in lower quartiles.

The overall rate of in-hospital mortality was 10.7 percent, which increased with higher PLR. For instance, patients in PLR Q1 saw an in-hospital mortality rate of 8.3 percent, while Q4 comparators had a corresponding rate of 13.9 percent (p<0.001).

Unadjusted logistic regression analysis confirmed that higher PLR was a significant indicator for in-hospital mortality, with Q4 participants seeing a nearly 80-percent increase in the likelihood of death than Q1 comparators (odds ratio [OR], 1.77, 95 percent confidence interval [CI], 1.39–2.25; p<0.001).

This association remained true even after adjusting for age, sex, ethnicity, and other confounders (OR, 1.55, 95 percent CI, 1.08–2.21, p=0.016; p-trend<0.001). Higher PLR quartiles were also correlated with prolonged CICU and hospital stay (p<0.001 for both).

“More attention should be paid to inexpensive, easily accessible indicators like PLR, which is more cost-effective, especially in some cases that more complex score could not be calculated,” such as when the patient is unable to undergo complicated tests or is in a remote area, the researchers said.