Relationship Between Platelet/Lymphocyte Ratio And Prognosis Of Acute Kidney Injury In Sepsis

Objective: To define if there is a certain relation between the new type nonspecific inflammatory marker of PLR and the prognosis of patients with sepsis-induced AKI.In order to accurately predict the prognosis of acute kidney injury patients with sepsis by Simple and economical means in the early stage and provide some theoretical reference for the epidemiological study of the prognosis of patients with sepsis AKI.Method: Single center,retrospective study.Using the diagnostic criteria for the 2015 International Conference on Sepsis(Sepsis 3.0): that is,a clear or suspicious presence of foci,with qSOFA score ? 2 points(Criteria: systolic blood pressure ? 100 mm Hg,1 point;GCS ? 13 points,1 Point;respiratory rate ? 22 beats / min,1 point)to evaluate sepsis diagnosis.According to KDIGO diagnostic criteria,subjects were divided into sepsis non-AKI group and sepsis AKI group,according to whether the patient survived 28 days after admission,then the sepsis AKI group was divided into sepsis AKI survival group and sepsis AKI non-survival group.Exclusion criteria: chronic renal failure;kidney transplant surgery;died within 48 h after admission;basic information missing;suffering from blood diseases;none of the above conditions are selected.The clinical parameters(including gender,age,temperature,heart rate,respiratory rate,blood pressure,APACHE-II score,whether mechanical ventilation,with or without other organ dysfunction)were collected within 24 hours after admission;the first relevant laboratory examination data after admission(including leukocytes,neutrophils,lymphocytes,platelets,PLR,arterial blood pH,arterial blood actual bicarbonate concentration,blood glucose,serum potassium,serum sodium,blood urea nitrogen,serum creatinine),28 days mortality after admission.Using SPSS 21.0software,and quantitative data was used for normal distribution test,the data of normal distribution were expressed as mean ± standard deviation,the data of non-normal distribution were expressed as median(interquartile range),and the classification data were expressed in counts.Quantitative data were compared using analysis of variance or non-parametric Wilcoxon test,classification data were compared using the X2 test.Logistic regression analysis was used to screen for the risk factors and the best CUT-OFF for PLR was determined.P <0.05 for thedifference was statistically significant.Results: A total of 158 patients were screened from January 01,2015 to January 1,2017.Of them,38 patients were excluded due to non-compliance with the relevant inclusion criteria,including 20 patients with chronic renal dysfunction,3 patients with hematological diseases,12 cases of ICU less than 48 hours died,3 cases of incomplete basic information.Finally there were120 clinical data.After statistical analysis,mechanical ventilation,platelet count,PLR,arterial blood lactate concentration and the prognosis of acute renal injury patients with sepsis have a correlation(P <0.05),in which the PLR OR is 1.010.The optimal CUT-OFF value for determining the prognosis of patients with PLR was 119.64.The CUT-OFF value of the sensitivity of 70.7%,specificity of 65.4%.Conclusions: Three factors,including mechanical ventilation,PLR and arterial lactate concentration were found to influence the prognosis of patients with acute renal injury in sepsis.At the same time,Logistic analysis of PLR,plot ROC curve,the area under the curve is 0.726,indicating that the PLR of patients with acute kidney injury in sepsis early admission can be used as a prompt diagnosis of acute sepsis patients with acute renal injury prognosis sensitive index.And the prediction method is simple,economical,effective,clinically easy to obtain,has good clinical application prospects.