Clinical significance of the neutrophil‐to‐lymphocyte ratio on the prognosis of critically ill elderly patients with sepsis— a retrospective study based on the MIMICV‐IV database

• DOI: 10.1002/hkj2.70008
• Publication Date: 2025-03-27T13:40:17Z
• Authors: Kun Han; Jian Hao Wang; Jin Shuai Lu
• Keywords: Clinical Significance

Abstract Introduction This study aimed to elucidate the relationship between neutrophil‐to‐lymphocyte ratio (neutrophil–lymphocyte ratio, NLR) and 28‐day mortality in critically ill elderly sepsis patients. Methods Retrieval of information on patients > 65 years age who meet diagnostic criteria for 3.0 using Medical Information Marketplace Intensive Care‐IV (MIMIC‐IV) database. Optimal NLR truncation was identified X‐tile software corresponding Kaplan–Meier (K‐M) survival curves were plotted. The ability combination with quick Sequential Organ Failure Assessment (qSOFA) both alone predict septic also assessed receiver operating characteristic curve. Least absolute shrinkage selection operator (LASSO) logistic regressions applied factors p < 0.05 establish a model. Area under curve (AUC), calibration curve, decision analysis utilized assess nomogram predictive accuracy. Results Among 2032 patients, 44.6% expired. K–M suggested that ≥ 13.6 significantly increased risk death. AUC combined qSOFA score 0.764, which higher than (0.728) (0.644) stronger power SOFA (0.738) but weaker Simplified Acute Physiology Score ( = 0.785). A constructed regression collected variables, culminating inclusion five factors: age, NLR, lactate, mechanical ventilation, qSOFA. showed good discrimination predicting Conclusion low levels (< 13.6) associated better survival. severe when two used SAPSII. LASSO effectively integrates multiple vital factors, showing clinical practicability, providing powerful tool evaluating prognosis sepsis.