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| 篇名 |
Change of neutrophil‑to‑monocyte ratio to stratify the mortality risk of adult patients with trauma in the intensive care units |
| 作者 |
Ching‑Hua Tsai1, Hang‑Tsung Liu1, Ting‑Min Hsieh1, Chun‑Ying Huang, Sheng‑En Chou, Wei‑Ti Su, Chi Li, Shiun‑Yuan Hsu, Ching‑Hua Hsieh |
| 卷期/出版年月 |
55卷5期 (2022/9) |
| 頁次 |
177-183 |
| 摘要 |
Background: The subtypes of circulating white blood cells undergo relative changes under systemic
inflammation; thus, the derived ratio may reflect patients’ immunoinflammatory status. Under the hypothesis
that change in segmented neutrophil‑to‑monocyte (SeMo) ratio, delta‑SeMo ratio, may reflect the host’s
immunoinflammatory response against illness, this study aims to investigate the effectiveness of using
delta‑SeMo ratio to assess the mortality risk of patients with trauma and critical illness.
Materials and Methods: A total of 1476 adult patients with trauma admitted to the intensive care unit (ICU)
between January 1, 2009, and December 31, 2020, were enrolled in this study. Delta‑SeMo ratio was
defined using the following formula: SeMo ratio at day 3 (72–96 h after admission into ICU) – SeMo ratio
at admission (at admission into ICU). The primary outcome was inhospital mortality.
Results: There was no significant difference in the SeMo ratio at admission between death and survival
patients (18.7 ± 11.0 vs. 18.7 ± 18.4, P = 0.974); however, SeMo ratio at day 3 (20.3 ± 15.5 vs. 15.7 ± 16.0,
P = 0.002) and delta‑SeMo ratio (1.6 ± 19.5 vs.–3.0 ± 24.2, P = 0.034) of the patients who died were
significantly higher than those of the patients who survived. The patients with delta‑SeMo ratio ≥1.038, an
estimated cutoff value for best predicting mortality by the plotted receiver operating characteristic curve,
sustained an approximately 2‑fold adjusted mortality (adjusted odds ratio [AOR]: 1.84, 95% confidence
interval [CI]: 1.27–2.66, P = 0.001) than those with a delta‑SeMo ratio <1.038. Furthermore, when the
delta‑SeMo ratio was set at 0, a threshold value indicating a condition with an increase or decrease in the SeMo
ratio at day 3 than the SeMo ratio at admission, there was a 1.7‑fold higher adjusted mortality (AOR: 1.70,
95% CI: 1.18–2.46, P = 0.004) of the patients with delta‑SeMo ratio ≥0 than those with delta‑SeMo ratio <0.
Conclusion: Following trauma injury, critically ill patients with an increased SeMo ratio present with a higher
rate of mortality and longer stay in the hospital and ICU than those with a decreased SeMo ratio. The use
of the delta‑SeMo ratio may help physicians quickly identify patients at higher risk of inhospital mortality. |
| 關鍵詞 |
Delta‑segmented neutrophil‑to‑monocyte, immune, mortality, segmented neutrophil‑to‑monocyte, trauma |
| 分類 |
Original Articles |
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