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. 2024 Sep 23;14(18):2102.
doi: 10.3390/diagnostics14182102.

Insights into the Neutrophil-to-Lymphocyte Ratio and the Platelet-to-Lymphocyte Ratio as Predictors for the Length of Stay and Readmission in Chronic Heart Failure Patients

Liviu Cristescu  1   2   3 , Ioan Tilea  3   4 , Dragos-Gabriel Iancu  2   3   4 , Florin Stoica  2   3 , Diana-Andreea Moldovan  1   2   5 , Vincenzo Capriglione  1 , Andreea Varga  1   3
Affiliations

Insights into the Neutrophil-to-Lymphocyte Ratio and the Platelet-to-Lymphocyte Ratio as Predictors for the Length of Stay and Readmission in Chronic Heart Failure Patients

Liviu Cristescu et al. Diagnostics (Basel). .

Abstract

Background/Objectives: Chronic heart failure (CHF) is characterized by complex pathophysiology, leading to increased hospitalizations and mortality. Inflammatory biomarkers such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) provide valuable diagnostic insights.

Methods: This study evaluates the prognostic relationship between NLR, PLR, and, in a specific subcohort, N-terminal pro B-type natriuretic peptide (NT-proBNP), alongside length of stay (LOS) and 90-day readmission rates in CHF patients, irrespective of heart failure phenotype. A retrospective analysis of 427 CHF admissions (males = 57.84%) was conducted.

Results: The mean age of the entire population was 68.48 ± 11.53 years. The average LOS was 8.33 ± 5.26 days, with a readmission rate of 73 visits (17.09%) for 56 patients. The NLR (3.79 ± 3.32) showed a low but positive correlation with the LOS (r = 0.222, p < 0.001). Conversely, the PLR (144.84 ± 83.08) did not demonstrate a significant association with the LOS. The NLR presented a low negative correlation for days until the next admission (r = -0.023, p = 0.048). In a prespecified subanalysis of 323 admissions, the NT-proBNP exhibited a low positive Pearson correlation with the NLR (r = 0.241, p < 0.001) and PLR (r = 0.151, p = 0.006).

Conclusions: The impact of the NLR across heart failure phenotypes may suggest the role of systemic inflammation in understanding and managing CHF.

Keywords: N-terminal pro B-type natriuretic peptide; chronic heart failure; length of stay; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio; readmission.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of study cohort selection. CHF, chronic heart failure; HFmrEF, heart failure with mildly reduced ejection fraction; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; n, number; NT-proBNP, N-terminal pro B-type natriuretic peptide; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio.
Figure 2
Figure 2
Distribution of NLR (left panel) and PLR (right panel) across NYHA functional classes. HFmrEF, heart failure with mildly reduced ejection fraction; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; NLR, neutrophil-to-lymphocyte ratio; NYHA, New York Heart Association; PLR, platelet-to-lymphocyte ratio. The horizontal line inside the floating bars refers to the median of the specified HF phenotype.
Figure 3
Figure 3
Readmission events within 90 days related to the HF phenotype. HFmrEF, heart failure with mildly reduced ejection fraction; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction.
Figure 4
Figure 4
Receiver operating characteristic (ROC) curves for NLR (left panel) and PLR (right panel) in predicting early readmission. NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio.
Figure 5
Figure 5
The NLR subgroup readmissions within 90 days after the first discharge. NLR, neutrophil-to-lymphocyte ratio.
Figure 6
Figure 6
The PLR subgroups readmissions within 90 days. PLR, platelet-to-lymphocyte ratio.
See this image and copyright information in PMC

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