Value of Platelet to Lymphocyte Ratio in Predicting in-hospital Death of Patients with Sepsis

Abstract

Objective: The aim of this study was to evaluate the value of platelet-to-lymphocyte ratio (PLR) in predicting in-hospital death in patients with sepsis.

Material and Methods: In this study, 260 patients with sepsis were examined. The APACHE II score was calculated in the first 24 hours of patient admission. The ability of three models (APACHE II, APACHE II with the addition of PLR, and PLR alone) in predicting in-hospital death of patients was compared according to the final outcome (death or discharge).

Results: The mean PLR in the surviving and deceased groups was 349 ± 617 and 376 ± 677, respectively (P = 0.74). The Brier score was determined for APACHE II (0.332±0.32), followed by APACHE II with PLR (0.19 ± 0.18) and PLR (0.25 ± 0.01). The AUROC number for these three prediction criteria was 0.70 ± 0.03, 0.77 ± 0.02 and 0.49 ± 0.03, respectively. In evaluating the calibration of these three prediction models, the p value was significant for APACHE II (P < 0.05). However, this value was not significant for APACHE II with PLR and PLR alone (P = 0.782 and P = 0.786), respectively Sensitivity, specificity, positive and negative predictive values for APACHE II were determined to be 68, 63, 65 and 67%, respectively. Furthermore, these values for APACHE II along with PLR were 60, 85, 80 and 68%, respectively. In addition, these values were calculated for the PLR to be 22, 84, 58, and 52%, respectively.

Conclusion: The PLR is an important risk factor for in-hospital death in patients with sepsis. Adding this to the criteria of the APACHE II system is capable of improving the accuracy of this method in predicting in-hospital death of patients.