Journal of Inflammation Research (Mar 2022)
The Neutrophil/Lymphocyte Ratio is an Independent Predictor of All-Cause Mortality in Patients with Idiopathic Hypereosinophilic Syndrome
Abstract
Junshuai Xue,* Jianjun Jiang,* Yang Liu Department of General Surgery, Vascular Surgery, Shandong University Qilu Hospital, Jinan City, Shandong Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yang Liu, Department of General Surgery, Vascular Surgery, Shandong University Qilu Hospital, No. 107, Road Wen Hua Xi, Jinan City, Shandong Province, 250012, People’s Republic of China, Tel +86 18560088317, Email [email protected]: Idiopathic hypereosinophilic syndrome (IHES) often causes inflammatory damage to multiple organs. However, whether immune/inflammatory indicators and other factors are associated with mortality in patients with IHES remains unclear.Patients and Methods: The clinical data and follow-up results of 167 patients with IHES were retrospectively analyzed using Cox regression analysis and receiver operating characteristic curve (ROC).Results: Of 167 patients, 120 were men (71.9%) and 47 were women (28.1%). The median age was 52 (36.0, 68.0) years. The median follow-up period was 42.8 (18.5, 75.1) months, during which all-cause mortality occurred in 26 patients (15.6%). Age (HR: 1.041, 95% CI: 1.015– 1.068; p = 0.002), lymphocyte counts (109/L, HR: 0.866, 95% CI: 0.816– 0.907; p = 0.013), platelet counts (109/L, HR: 0.994, 95% CI: 0.989– 0.999; p = 0.012) and NLR (HR: 1.161, 95% CI: 1.054– 1.280; p = 0.003) were independent risk factors for all-cause mortality. There was no relationship between PLR, and SII and all-cause mortality (p = 0.181 and 0.202, respectively). ROC analysis showed that the AUCs of age, lymphocyte count (109/L), platelet count (109/L) and NLR were 0.712 (95% CI: 0.601– 0.824), 0.584 (95% CI: 0.448– 0.719), 0.686 (95% CI: 0.560– 0.812), and 0.797 (95% CI: 0.695– 0.899), respectively, with sensitivities of 0.5, 0.462, 0.769, and 0.792, respectively, and specificities of 0.765, 0.745, 0.617, and 0.845, respectively. Kaplan–Meier analysis (Log rank test) showed that patients with age ≥ 73.5 years, lymphocyte count (109/L) < 1.45, platelet count (109/L) < 225 and NLR ≥ 2.54 had high mortality. Patients with high NLR (≥ 2.54) usually have multiorgan involvement, with cardiac involvement and skin involvement being the most common. Patients with NLR ≥ 2.54 had significantly higher absolute eosinophil counts (p = 0.047) and percentages (p = 0.041).Conclusion: We identified NLR for the first time as an independent predictive factor for all-cause mortality in patients with IHES, necessitating its further application in clinical practice.Keywords: idiopathic hypereosinophilic syndrome, mortality, risk variable, neutrophil/lymphocyte ratio
