Low lymphocyte to high-density lipoprotein ratio predicts mortality in sepsis patients

Wanjun Liu; Qian Tao; Jun Xiao; Yijun Du; Tianrong Pan; Yue Wang; Xing Zhong

doi:10.3389/fimmu.2023.1279291

Low lymphocyte to high-density lipoprotein ratio predicts mortality in sepsis patients

Front Immunol. 2023 Oct 12:14:1279291. doi: 10.3389/fimmu.2023.1279291. eCollection 2023.

Authors

Wanjun Liu¹, Qian Tao², Jun Xiao³, Yijun Du², Tianrong Pan², Yue Wang², Xing Zhong²

Affiliations

¹ Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
² Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
³ School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, China.

Abstract

Background: The lymphocyte-to-high-density lipoprotein (HDL) ratio (LHR) is associated with both inflammation and immunity, and may have the potential to predict the prognosis of sepsis. Our study aimed to evaluate the relationship between LHR and sepsis-related mortality.

Methods: We collected data from the Medical Information Mart for Intensive Care IV (MIMIC-IV, version 2.2) database by targeting patients who met the Sepsis-3 criteria and recorded the absolute values of lymphocytes and HDL after admission. We then used restricted cubic splines based on logistic regression to simulate the relationship between the LHR and 90-day mortality. Subsequently, the hazardous threshold was derived based on the mortality curve, and further evaluations were performed using different methods and data sources for hazardous threshold.

Results: We ultimately included 1027 eligible patients from the MIMIC-IV database and described the nonlinear relationship between LHR and 90-day mortality. Based on the curve, an LHR of ≤ 0.6 indicated harmful threshold, and the odds ratio for mortality was 1.74 (P=0.001). The outperforming hazard was particularly marked in patients with chronic lung disease and remained consistent after adjusting for baseline data and validating multiple data sources.

Conclusions: The LHR has prognostic value in patients with sepsis, and an LHR ≤ 0.6 is a deleterious load that increases mortality.

Keywords: immunity; inflammation; lipoprotein; lymphocyte; mortality; prognosis; sepsis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Critical Care
Databases, Factual
Humans
Lipoproteins, HDL
Lymphocytes
Sepsis*

Substances

Lipoproteins, HDL

Grants and funding

The authors declare financial support was received for the research, authorship, and/or publication of this article. This study funded by Anhui Medical University School-level Science Fund Project(2020xkj200).