Background

Cellular indices provide integrative information about systemic inflammation status which is readily available from routine laboratory parameters. This study aimed to evaluate the prognostic role of three cellular indices in patients with venous thromboembolism (VTE).

Methods

The RIETE registry database was used to determine the association between the baseline neutrophil-to-lymphocyte-ratio (NLR), platelet-to-lymphocyte-ratio (PLR) and systemic-immune-inflammation-index (SII) for 90-day adverse outcomes in patients with acute VTE.

Results

From January 2020 to April 2021, 4487 patients with acute VTE were recruited in the RIETE registry. Of these, 2683 presented with symptomatic pulmonary embolism (PE); 283 with incidental PE; 1129 with lower-limb deep vein thrombosis (DVT); 175 with upper-limb DVT; 69 with splanchnic vein thrombosis; 142 with superficial vein thrombosis and 20 with retinal vein thrombosis. Mean values were: NLR 5.9 ± 7.1, PLR 190 ± 158 and SII 1459 ± 2028. During the first 90-days, 38 patients (0.8%) developed recurrent DVT, 45 (1.0%) had recurrent PE, 152 (3.4%) suffered major bleeding, and 484 (11%) died. On multivariable analysis, patients with NLR >4.41 were at an increased risk for major bleeding and patients with NLR >4.96 were at the risk of death, while those with SII >1134.5 were at increased risk for death.

Conclusions

This study reports the results of a large cohort to date which evaluate the prognostic value of three cellular indices simultaneously in patients with acute VTE. Results support that none of the three baseline cellular indices were sufficient for prediction of VTE recurrences in acute VTE patients. The patients with higher baseline NLR values were at an increased risk of major bleeding or death, those with high SII values were only at an increased risk for mortality.

中文翻译：

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急性静脉血栓栓塞患者的细胞指标和预后

背景

细胞指数提供有关全身炎症状态的综合信息，这些信息可从常规实验室参数中轻松获得。本研究旨在评估三种细胞指标在静脉血栓栓塞 (VTE) 患者中的预后作用。

方法

RIETE 注册数据库用于确定 90 天不良反应的基线中性粒细胞与淋巴细胞比率 (NLR)、血小板与淋巴细胞比率 (PLR) 和全身免疫炎症指数 (SII) 之间的关联急性 VTE 患者的预后。

结果

从 2020 年 1 月到 2021 年 4 月，RIETE 登记处招募了 4487 名急性 VTE 患者。其中，2683 人出现症状性肺栓塞（PE）；283 附带 PE；1129 例下肢深静脉血栓形成 (DVT)；175 上肢 DVT；69 有内脏静脉血栓形成；142 例浅静脉血栓形成，20 例视网膜静脉血栓形成。平均值为：NLR 5.9 ± 7.1、PLR 190 ± 158 和 SII 1459 ± 2028。在最初的 90 天内，38 名患者 (0.8%) 出现复发性 DVT，45 名 (1.0%) 复发性 PE，152 名 (3.4%)大出血，484 人（11%）死亡。在多变量分析中，NLR > 4.41 的患者发生大出血的风险增加，NLR > 4.96 的患者有死亡风险，而 SII > 1134.5 的患者死亡风险增加。

结论

本研究报告了迄今为止一个大型队列的结果，该队列同时评估了三种细胞指标对急性 VTE 患者的预后价值。结果支持三个基线细胞指标都不足以预测急性 VTE 患者的 VTE 复发。基线 NLR 值较高的患者发生大出血或死亡的风险增加，而 SII 值较高的患者死亡风险仅增加。