Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio Are Superior to Other Inflammation-Based Prognostic Scores in Predicting the Mortality of Patients With Gastrointestinal Perforation

JA Clin Rep. 2017;3(1):49. doi: 10.1186/s40981-017-0118-1. Epub 2017 Sep 2.


Background: The neutrophil to lymphocyte ratio (NLR) is gaining interest as an independent predictor of survival in patients with various clinical conditions. No study to date has reported an association between inflammation-based prognostic scores, including the Glasgow Prognostic Score (GPS), NLR, platelet to lymphocyte ratio (PLR), Prognostic Nutritional Index (PNI), and Prognostic Index (PI), and mortality in patients with gastrointestinal perforation (GIP). We compared the prognostic value of these measures.

Findings: A total of 32 patients with GIP were retrospectively enrolled. Patients were assessed according to the GPS, NLR, PLR, PI, and PNI. Multivariate analyses were performed to identify variables associated with mortality. Receiver operating characteristic (ROC) analyses were also performed. Overall survival rates (in-hospital mortality) were calculated using the Kaplan-Meier method, and differences in survival rates between groups were compared by the log-rank test. Multivariate analysis of significant variables revealed NLR (HR 1.257, 95% CI 1.035-1.527, P = 0.021) and PLR (HR 1.004, 95% CI 1.001-1.007, P = 0.016) at the time of admission to the intensive care unit to be independently associated with in-hospital mortality. AUC analysis revealed Sequential Organ Failure Assessment-Glasgow Coma Scale (SOFA-GCS) (0.73) to be superior to NLR (0.57) and PLR (0.58) for predicting mortality, and a high SOFA-GCS score was associated with reduced overall survival (P < 0.05).

Conclusions: NLR and PLR were superior to other inflammation-based prognostic scores in predicting the mortality of patients with GIP.

Keywords: Gastrointestinal perforation; In-hospital mortality; Inflammation-based prognostic score.