Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Sep;18(3):215-222.
doi: 10.14744/AnatolJCardiol.2017.7716. Epub 2017 Jul 25.

Changes in neutrophil-to-lymphocyte ratios in postcardiac arrest patients treated with targeted temperature management

Kazım Başer  1 , Hatice Duygu Baş, Pavan Attaluri, Terrance Rodrigues, Jacob Nichols, Kennetht Nugen
Affiliations

Changes in neutrophil-to-lymphocyte ratios in postcardiac arrest patients treated with targeted temperature management

Kazım Başer et al. Anatol J Cardiol. 2017 Sep.

Abstract

Objective: The prognostic value of changes in neutrophil-to-lymphocyte ratios (NLR) in cardiac arrest survivors receiving targeted temperature management (TTM) is unknown. The current study investigated NLR in postcardiac arrest (PCA) patients undergoing TTM.

Methods: This retrospective single-center study included 95 patients (59 males, age: 55.0±17.0 years) with in-hospital and out-of-hospital cardiac arrests who underwent TTM for PCA syndrome within 6 h of cardiac arrest. Hypothermia was maintained for 24 h at a target temperature of 33°C. NLR was calculated as the absolute neutrophil count divided by the absolute lymphocyte count.

Results: Of the 95 patients, 59 (62%) died during hospital stay. Fewer vasopressors were used in patients who survived. Out-of-hospital cardiac arrest was more frequent in decedents (p=0.005). Length of stay in the hospital and intensive care unit were significantly longer in patients who survived (p=0.0001 and p=0.001, respectively). NLR on admission and during rewarming did not differ between survivors and decedents. NLR during cooling was significantly higher in decedents (p=0.014). Delta NLR cut-off of 13.5 best separated survivors and decedents (AUC=0.68, 95% CI: 0.57-0.79, p=0.003 with a sensitivity and specificity of 64% and 67%, respectively). In multivariate logistic regression analysis, larger increase in NLR was significantly associated with decreased survival (OR: 0.96, 95% CI: 0.94-0.99, p=0.008).

Conclusion: Changes in NLR are an independent determinant of survival in patients with return of spontaneous circulation PCA treated with TTM. An NLR change can be used to predict survival in these patients.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Mean NLR on admission, during cooling, and rewarming phases of TTM in survivors and decedents
Figure 2
Figure 2
Receiver operator characteristics. Area under curve=0.68, 95% CI (0.57–0.79), P=0.003. Delta NLR cutoff of 13.5 has a sensitivity and specificity of 64% and 67% respectively to separate survival vs death
Figure 3
Figure 3
Delta NLR during treatment phases of TTM. Error bars indicate ±1 standard error
None
Biochemist, MD. Meral Egüz’s collections
See this image and copyright information in PMC

References

    1. Polderman KH. Mechanisms of action, physiological effects, and complications of hypothermia. Crit Care Med. 2009;37:S186–202. - PubMed
    1. Peberdy MA, Callaway CW, Neumar RW, Geocadin RG, Zimmerman JL, Donnino M, et al. Part 9:post-cardiac arrest care:2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122:S768–86. - PubMed
    1. Aibiki M, Maekawa S, Ogura S, Kinoshita Y, Kawai N, Yokono S. Effect of moderate hypothermia on systemic and internal jugular plasma IL-6 levels after traumatic brain injury in humans. J Neurotrauma. 1999;16:225–32. - PubMed
    1. Jenkins DD, Lee T, Chiuzan C, Perkel JK, Rollins LG, Wagner CL, et al. Altered circulating leukocytes and their chemokines in a clinical trial of therapeutic hypothermia for neonatal hypoxic ischemic encephalopathy. Pediatr Crit Care Med. 2013;14:786–95. - PubMed
    1. Scirica BM. Therapeutic hypothermia after cardiac arrest. Circulation. 2013;127:244–50. - PubMed

Publication types

LinkOut - more resources