Assessment of inflammatory markers, disease severity and comorbidities in very elderly patients with acute respiratory diseases
Introduction The study aimed to evaluate the potential role of inflammatory markers (neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), platelet to mean platelet volume (PLT/MPV), C-reactive protein (CRP), CRP/albumin) and demographic, clinical and laboratory parameters in pre...
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Termedia Publishing House
2020-04-01
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| Series: | Archives of Medical Science |
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| Online Access: | https://www.archivesofmedicalscience.com/Assessment-of-inflammatory-markers-disease-severity-and-comorbidities-in-very-elderly,119018,0,2.html |
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| author | Armagan Hazar Baran Gundogus |
| author_facet | Armagan Hazar Baran Gundogus |
| author_sort | Armagan Hazar |
| collection | DOAJ |
| description | Introduction
The study aimed to evaluate the potential role of inflammatory markers (neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), platelet to mean platelet volume (PLT/MPV), C-reactive protein (CRP), CRP/albumin) and demographic, clinical and laboratory parameters in predicting mortality in elderly patients.
Material and methods
A total of 1971 very elderly (age ≥ 80 years) patients hospitalized due to acute respiratory diseases were included in this retrospective cohort study. Data on patients’ demographics, reasons for admission, comorbidities, inflammatory markers on admission, hospitalization unit, length of hospital stay and survivorship status were recorded. A receiver operating characteristics (ROC) curve was plotted to determine performance of inflammatory marker levels for mortality risk. Logistic regression analysis for hospital mortality was used.
Results
A total of 1971 patients were admitted, in-ward ( n = 1470), intensive care unit (ICU, n = 352), or palliative care unit (PCU, n = 149), and mortality rates were 12.7% ( n = 250), 4.5% ( n = 66), 34.9% ( n = 123), 40.9% ( n = 61) respectively. ROC analysis for area under curve (AUC) revealed significant cut-off levels for hospital mortality NLR ≥ 7.75 (AUC = 0.79), CRP ≥ 44 (AUC = 0.82); CRP/albumin ≥ 13.5 (AUC = 0.84) each p < 0.001. For ICU mortality, the cut-off values and AUC were significant respectively for NLR ≥ 7.75 (AUC = 0.82), CRP ≥ 60 (AUC = 0.82), APACHE II ≥ 24 (AUC = 0.76), CRP/albumin ≥ 26 (AUC = 0.78), PLT/MPV < 26.2 (AUC = 0.31) (each p < 0.001). Binary logistic regression revealed that age above 90, PCU and ICU admission, acute and chronic renal failure and NLR ≥ 7.75 were significant mortality predictors (odds ratio, 95% CI, p -value: 2.57, 1.05–6.31, 0.039; 77.18, 18.98–313.81, < 0.001; 20.75, 1.96–98.73, < 0.001; 18.99, 1.31–275.31, 0.031; 3.35, 1.06–10.54, 0.039; 7.83, 3.34–18.38, 0.001).
Conclusions
Very elderly patients with respiratory diseases who are admitted to the ICU or PCU with acute and chronic renal failure requiring ICU admission and with NLR values above 7.75 on admission have very high risk for mortality. |
| format | Article |
| id | doaj-art-3d32f13ac0c1405aac205357ddf5ebff |
| institution | OA Journals |
| issn | 1734-1922 1896-9151 |
| language | English |
| publishDate | 2020-04-01 |
| publisher | Termedia Publishing House |
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| series | Archives of Medical Science |
| spelling | doaj-art-3d32f13ac0c1405aac205357ddf5ebff2025-08-20T01:50:38ZengTermedia Publishing HouseArchives of Medical Science1734-19221896-91512020-04-0121245146210.5114/aoms.2020.94495119018Assessment of inflammatory markers, disease severity and comorbidities in very elderly patients with acute respiratory diseasesArmagan Hazar0Baran Gundogus1Department of Pulmonary Disease, Sureyyapasa Chest Disease and Thoracic Surgery, Training and Research Hospital, Health Sciences University, Istanbul, TurkeyDepartment of Pulmonary Disease, Sureyyapasa Chest Disease and Thoracic Surgery, Training and Research Hospital, Health Sciences University, Istanbul, TurkeyIntroduction The study aimed to evaluate the potential role of inflammatory markers (neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), platelet to mean platelet volume (PLT/MPV), C-reactive protein (CRP), CRP/albumin) and demographic, clinical and laboratory parameters in predicting mortality in elderly patients. Material and methods A total of 1971 very elderly (age ≥ 80 years) patients hospitalized due to acute respiratory diseases were included in this retrospective cohort study. Data on patients’ demographics, reasons for admission, comorbidities, inflammatory markers on admission, hospitalization unit, length of hospital stay and survivorship status were recorded. A receiver operating characteristics (ROC) curve was plotted to determine performance of inflammatory marker levels for mortality risk. Logistic regression analysis for hospital mortality was used. Results A total of 1971 patients were admitted, in-ward ( n = 1470), intensive care unit (ICU, n = 352), or palliative care unit (PCU, n = 149), and mortality rates were 12.7% ( n = 250), 4.5% ( n = 66), 34.9% ( n = 123), 40.9% ( n = 61) respectively. ROC analysis for area under curve (AUC) revealed significant cut-off levels for hospital mortality NLR ≥ 7.75 (AUC = 0.79), CRP ≥ 44 (AUC = 0.82); CRP/albumin ≥ 13.5 (AUC = 0.84) each p < 0.001. For ICU mortality, the cut-off values and AUC were significant respectively for NLR ≥ 7.75 (AUC = 0.82), CRP ≥ 60 (AUC = 0.82), APACHE II ≥ 24 (AUC = 0.76), CRP/albumin ≥ 26 (AUC = 0.78), PLT/MPV < 26.2 (AUC = 0.31) (each p < 0.001). Binary logistic regression revealed that age above 90, PCU and ICU admission, acute and chronic renal failure and NLR ≥ 7.75 were significant mortality predictors (odds ratio, 95% CI, p -value: 2.57, 1.05–6.31, 0.039; 77.18, 18.98–313.81, < 0.001; 20.75, 1.96–98.73, < 0.001; 18.99, 1.31–275.31, 0.031; 3.35, 1.06–10.54, 0.039; 7.83, 3.34–18.38, 0.001). Conclusions Very elderly patients with respiratory diseases who are admitted to the ICU or PCU with acute and chronic renal failure requiring ICU admission and with NLR values above 7.75 on admission have very high risk for mortality.https://www.archivesofmedicalscience.com/Assessment-of-inflammatory-markers-disease-severity-and-comorbidities-in-very-elderly,119018,0,2.htmlinflammatory markersalbuminin hospital mortalityintensive care unitvery elderly |
| spellingShingle | Armagan Hazar Baran Gundogus Assessment of inflammatory markers, disease severity and comorbidities in very elderly patients with acute respiratory diseases Archives of Medical Science inflammatory markers albumin in hospital mortality intensive care unit very elderly |
| title | Assessment of inflammatory markers, disease severity and comorbidities in very elderly patients with acute respiratory diseases |
| title_full | Assessment of inflammatory markers, disease severity and comorbidities in very elderly patients with acute respiratory diseases |
| title_fullStr | Assessment of inflammatory markers, disease severity and comorbidities in very elderly patients with acute respiratory diseases |
| title_full_unstemmed | Assessment of inflammatory markers, disease severity and comorbidities in very elderly patients with acute respiratory diseases |
| title_short | Assessment of inflammatory markers, disease severity and comorbidities in very elderly patients with acute respiratory diseases |
| title_sort | assessment of inflammatory markers disease severity and comorbidities in very elderly patients with acute respiratory diseases |
| topic | inflammatory markers albumin in hospital mortality intensive care unit very elderly |
| url | https://www.archivesofmedicalscience.com/Assessment-of-inflammatory-markers-disease-severity-and-comorbidities-in-very-elderly,119018,0,2.html |
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