To Investigate The Predictive Value Of N/LPR For 28-day Death In Patients With Acute Lung Injury Due To Sepsis

Objective: To evaluate the value of peripheral blood neutrophil count to lymphocyte and platelet count ratio(N/LPR)in predicting 28-day death in patients with septic associated acute lung injury(SALI).Methods:The patients with SALI diagnosed in ICU of the First Hospital of Hebei Medical University from January 2022 to November 2022 were selected as the study subjects.Collect the clinical data of eligible patients and laboratory test results within 24 hours after diagnosis of SALI,including neutrophil count(NEU),lymphocyte count(LYM)and platelet count(PLT),and calculate the ratio of neutrophil count to lymphocyte count(NLR)and N/LPR.According to the 28 natural survival status of SALI patients,SALI patients were divided into survival group and death group;Logistic regression analysis was used to determine the independent risk factors affecting the prognosis of patients with SALI;The predictive value of N/LPR and NLR for 28-day death in SALI patients was evaluated using receiver operating characteristic curve(ROC)and area under curve(AUC),and the optimal cut-off value was determined.The 28-day mortality of SALI patients was analyzed by subgroup analysis according to the optimal cut-off value,and Kaplan-Meier survival curve was drawn to analyze the 28-day survival probability of SALI patients.Results: Excluding unqualified patients,a total of 81 SALI patients were included in the study.They were divided into survival group(n=47)and death group(n=34)according to their survival status on the 28 th day.Compared with the survival group,the N/LPR and NLR in the death group were significantly higher(N/LPR: 17.46 ± 3.84 vs 13.08 ± 3.98,NLR: 21.67 ± 3.91 vs 18.40 ± 4.00),while the PLT was significantly lower(PLT: 95.74 ± 23.90 vs 113.79 ± 25.31),the difference was statistically significant(both P<0.05).Logistic regression analysis showed that N/LPR(OR=1.415,95%CI=1.172-1.708),NLR(OR=1.234,95%CI=1.055-1.443)and PLT(OR=0.971,95% CI=0.952-0.990)were independent risk factors for 28-day death in SALI patients(all P<0.05).The ROC curve analysis showed that the area under the ROC curve(AUC)of N/LPR,NLR and PLT predicting the 28-day death of SALI patients was 0.789,0.722 and 0.700,respectively,and N/LPR was higher than NLR and PLT(AUC: 0.789 vs 0.722 vs 0.700);Taking 15.053 as the best cutoff value of N/LPR to predict the 28-day death of SALI patients,the sensitivity is 76.5%,and the specificity is 74.5%,which is a more reliable predictor of the 28-day death of SALI patients.Subgroup analysis showed that the 28-day mortality rate of SALI patients in N/LPR ≥ 15.053 group(n=38)was significantly higher than that in N/LPR<15.053 group(n=43),and the survival time was significantly shorter than that in N/LPR<15.053 group(68.4% vs 18.6%;7.15 d vs 13d;P<0.05);Further mapping of Kaplan-Meier survival curve can confirm the above results.Conclusion:1.N/LPR,NLR and PLT are independent risk factors for 28-day death in SALI patients.2.The predictive value of N/LPR was superior to that of NLR and was a more reliable predictor of 28-day death in SALI patients.