Abstract
Background
The objective of this study was to test the hypothesis that an elevated neutrophil
to lymphocyte ratio (NLR) at admission is associated with and increased risk of mortality
in older patients admitted to the emergency department (ED).
Methods
We performed a retrospective analysis of patients admitted to the ED between November
2016 and February 2017. We included patients who were older than 65 years who visited
the ED with any medical problem. We excluded patients with hematologic malignancy.
Baseline NLR values were measured at the time of admission to the ED. The primary
outcome was all-cause in-hospital mortality. A multivariate logistic analysis was
performed.
Results
A total of 2777 patients were included in this study. The median age was 75 years
(IQR 70–81), and 1359 (48.9%) patients were male. The in-hospital mortality rate was
5.0% (140 patients). The NLR value was higher in nonsurvivors (median, 8.08, IQR 4.29–15.25)
than in survivors (median, 3.69, IQR 2.1–6.92, P < 0.001). In the multivariate logistic
regression analysis, the NLR was associated with all cause in-hospital mortality after
adjusting for confounding factors (OR = 1.03, 95% CI = 1.014–1.046).
Conclusions
These results show that the NLR at admission is associated with in-hospital mortality
among patients older than 65 years without hematologic malignancy. Thus, NLR at admission
may represent a surrogate marker of disease severity.
Keywords
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Article Info
Publication History
Published online: January 24, 2020
Accepted:
January 24,
2020
Received in revised form:
December 19,
2019
Received:
August 16,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
