Effect of lymphocyte-to-monocyte ratio on survival in septic patients: an observational cohort study

Abstract

IntroductionThe purpose of the present study was to evaluate the potential relationship of lymphocyte-to-monocyte ratio (LMR) with outcomes of septic patients at intensive care unit (ICU) admission.Material and methods3087 septic patients were included in the final cohort by using the Medical Information Mart for Intensive Care (MIMIC) database. We evaluated the association of different groups of LMR_max with 28-day survival and 1-year survival via Kaplan-Meier (K-M) analysis and Cox regression analysis. Subgroups analysis of LMR_max was performed to further explore the effect of LMR_max on survival.ResultsAccording to the optimal cut-off value, the cohort was divided into low-LMR_max and high-LMR_max groups. The 28-day and 1-year survival rates were 47.9% and 19.9%, respectively, in the low-LMR_max group, and 60.4% and 25.9%, respectively, in the high-LMR_max group. Univariate logistic regression and K-M analyses revealed that the 28-day and 1-year survival rates of the high-LMR_max group were higher than those of the low-LMR_max group (both p < 0.001). A subgroup analysis of LMR_max identified a significant stepwise decrease in the risk of death at 28 days and 1 year from group 1 to group 4 (LMR_max increased gradually) after adjustment for multiple variables.ConclusionsWe report for the first time that a lower LMR_max value is independently predictive of a poor prognosis in septic patients. Therefore, as an inexpensive and readily available indicator, LMR_max may facilitate stratification of prognosis in septic patients.