Association of Platelets and White Blood Cells Subtypes with Trauma Patients’ Mortality Outcome in the Intensive Care Unit
<b>Background:</b> White blood cell (WBC) subtypes have been suggested to reflect patients’ immune-inflammatory status. Furthermore, the derived ratio of platelets and WBC subtypes, including monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lympho...
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doaj-d061f8622af24781a71ef4f8f860c0bb2021-08-26T13:47:35ZengMDPI AGHealthcare2227-90322021-07-01994294210.3390/healthcare9080942Association of Platelets and White Blood Cells Subtypes with Trauma Patients’ Mortality Outcome in the Intensive Care UnitRuei-Ti Ke0Cheng-Shyuan Rau1Ting-Min Hsieh2Sheng-En Chou3Wei-Ti Su4Shiun-Yuan Hsu5Ching-Hua Hsieh6Hang-Tsung Liu7Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan<b>Background:</b> White blood cell (WBC) subtypes have been suggested to reflect patients’ immune-inflammatory status. Furthermore, the derived ratio of platelets and WBC subtypes, including monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), is proposed to be associated with patient outcome. Therefore, this study aimed to identify the association of platelets and white blood cells subtypes with the mortality outcome of trauma patients in the intensive care unit (ICU). <b>Method:</b> The medical information from 2854 adult trauma patients admitted to the ICU between 1 January 2009 and 31 December 2019 were retrospectively retrieved from the Trauma Registry System and classified into two groups: the survivors group (<i>n</i> = 2524) and the death group (<i>n</i> = 330). The levels of monocytes, neutrophils, lymphocytes, platelets, and blood-drawn laboratory data detected upon patient arrival to the emergency room and the derived MLR, NLR, and PLR were calculated. Multivariate logistic regression analysis was used to determine the independent effects of univariate predictive variables on mortality occurrence. <b>Result:</b> The results revealed the patients who died had significantly lower platelet counts (175,842 ± 61,713 vs. 206,890 ± 69,006/μL, <i>p</i> < 0.001) but higher levels of lymphocytes (2458 ± 1940 vs. 1971 ± 1453/μL, <i>p</i> < 0.001) than the surviving patients. However, monocyte and neutrophil levels were not significantly different between the death and survivor groups. Moreover, dead patients had a significantly lower PLR than survivors (124.3 ± 110.3 vs. 150.6 ± 106.5, <i>p</i> < 0.001). However, there was no significant difference in MLR or NLR between the dead patients and the survivors. Multivariate logistic regression revealed that male gender, old age, pre-existing hypertension, coronary artery disease and end-stage renal disease, lower Glasgow Coma Scale (GCS), higher Injury Severity Score (ISS), higher level of lymphocytes and lower level of red blood cells and platelets, longer activated partial thromboplastin time (aPTT), and lower level of PLR were independent risk factors associated with higher odds of trauma patient mortality outcome in the ICU. <b>Conclusion:</b> This study revealed that a higher lymphocyte count, lower platelet count, and a lower PLR were associated with higher risk of death in ICU trauma patients.https://www.mdpi.com/2227-9032/9/8/942white blood cellmonocyte-to-lymphocyte rationeutrophil-to-lymphocyte ratioplatelet-to-lymphocyte ratiointensive care unit |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ruei-Ti Ke Cheng-Shyuan Rau Ting-Min Hsieh Sheng-En Chou Wei-Ti Su Shiun-Yuan Hsu Ching-Hua Hsieh Hang-Tsung Liu |
spellingShingle |
Ruei-Ti Ke Cheng-Shyuan Rau Ting-Min Hsieh Sheng-En Chou Wei-Ti Su Shiun-Yuan Hsu Ching-Hua Hsieh Hang-Tsung Liu Association of Platelets and White Blood Cells Subtypes with Trauma Patients’ Mortality Outcome in the Intensive Care Unit Healthcare white blood cell monocyte-to-lymphocyte ratio neutrophil-to-lymphocyte ratio platelet-to-lymphocyte ratio intensive care unit |
author_facet |
Ruei-Ti Ke Cheng-Shyuan Rau Ting-Min Hsieh Sheng-En Chou Wei-Ti Su Shiun-Yuan Hsu Ching-Hua Hsieh Hang-Tsung Liu |
author_sort |
Ruei-Ti Ke |
title |
Association of Platelets and White Blood Cells Subtypes with Trauma Patients’ Mortality Outcome in the Intensive Care Unit |
title_short |
Association of Platelets and White Blood Cells Subtypes with Trauma Patients’ Mortality Outcome in the Intensive Care Unit |
title_full |
Association of Platelets and White Blood Cells Subtypes with Trauma Patients’ Mortality Outcome in the Intensive Care Unit |
title_fullStr |
Association of Platelets and White Blood Cells Subtypes with Trauma Patients’ Mortality Outcome in the Intensive Care Unit |
title_full_unstemmed |
Association of Platelets and White Blood Cells Subtypes with Trauma Patients’ Mortality Outcome in the Intensive Care Unit |
title_sort |
association of platelets and white blood cells subtypes with trauma patients’ mortality outcome in the intensive care unit |
publisher |
MDPI AG |
series |
Healthcare |
issn |
2227-9032 |
publishDate |
2021-07-01 |
description |
<b>Background:</b> White blood cell (WBC) subtypes have been suggested to reflect patients’ immune-inflammatory status. Furthermore, the derived ratio of platelets and WBC subtypes, including monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), is proposed to be associated with patient outcome. Therefore, this study aimed to identify the association of platelets and white blood cells subtypes with the mortality outcome of trauma patients in the intensive care unit (ICU). <b>Method:</b> The medical information from 2854 adult trauma patients admitted to the ICU between 1 January 2009 and 31 December 2019 were retrospectively retrieved from the Trauma Registry System and classified into two groups: the survivors group (<i>n</i> = 2524) and the death group (<i>n</i> = 330). The levels of monocytes, neutrophils, lymphocytes, platelets, and blood-drawn laboratory data detected upon patient arrival to the emergency room and the derived MLR, NLR, and PLR were calculated. Multivariate logistic regression analysis was used to determine the independent effects of univariate predictive variables on mortality occurrence. <b>Result:</b> The results revealed the patients who died had significantly lower platelet counts (175,842 ± 61,713 vs. 206,890 ± 69,006/μL, <i>p</i> < 0.001) but higher levels of lymphocytes (2458 ± 1940 vs. 1971 ± 1453/μL, <i>p</i> < 0.001) than the surviving patients. However, monocyte and neutrophil levels were not significantly different between the death and survivor groups. Moreover, dead patients had a significantly lower PLR than survivors (124.3 ± 110.3 vs. 150.6 ± 106.5, <i>p</i> < 0.001). However, there was no significant difference in MLR or NLR between the dead patients and the survivors. Multivariate logistic regression revealed that male gender, old age, pre-existing hypertension, coronary artery disease and end-stage renal disease, lower Glasgow Coma Scale (GCS), higher Injury Severity Score (ISS), higher level of lymphocytes and lower level of red blood cells and platelets, longer activated partial thromboplastin time (aPTT), and lower level of PLR were independent risk factors associated with higher odds of trauma patient mortality outcome in the ICU. <b>Conclusion:</b> This study revealed that a higher lymphocyte count, lower platelet count, and a lower PLR were associated with higher risk of death in ICU trauma patients. |
topic |
white blood cell monocyte-to-lymphocyte ratio neutrophil-to-lymphocyte ratio platelet-to-lymphocyte ratio intensive care unit |
url |
https://www.mdpi.com/2227-9032/9/8/942 |
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