PDF(Pubmed)
Abstract：
This study aimed to validate the role of the D-dimer to lymphocyte ratio (DLR) for mortality prediction in a large national cohort of hospitalized coronavirus disease 2019 (COVID-19) patients.
A retrospective, multicenter, observational study that included hospitalized patients due to SARS-CoV-2 infection in Spain was conducted from March 2020 to March 2022. All biomarkers and laboratory indices analyzed were measured once at admission.
A total of 10,575 COVID-19 patients were included in this study. The mean age of participants was 66.9 (±16) years, and 58.6% (6202 patients) of them were male. The overall mortality rate was 16.3% (n = 1726 patients). Intensive care unit admission was needed in 10.5% (n = 1106 patients), non-invasive mechanical ventilation was required in 8.8% (n = 923 patients), and orotracheal intubation was required in 7.5% (789 patients). DLR presented a c-statistic of 0.69 (95% CI, 0.68-0.71) for in-hospital mortality with an optimal cut-off above 1. Multivariate analysis showed an independent association for in-hospital mortality for DLR > 1 (adjusted OR 2.09, 95% CI 1.09-4.04; p = 0.03); in the same way, survival analysis showed a higher mortality risk for DLR > 1 (HR 2.24; 95% CI 2.03-2.47; p < 0.01). Further, no other laboratory indices showed an independent association for mortality in multivariate analysis.
This study confirmed the usefulness of DLR as a prognostic biomarker for mortality associated with SARS-CoV-2 infection, being an accessible, cost-effective, and easy-to-use biomarker in daily clinical practice.
A retrospective, multicenter, observational study that included hospitalized patients due to SARS-CoV-2 infection in Spain was conducted from March 2020 to March 2022. All biomarkers and laboratory indices analyzed were measured once at admission.
A total of 10,575 COVID-19 patients were included in this study. The mean age of participants was 66.9 (±16) years, and 58.6% (6202 patients) of them were male. The overall mortality rate was 16.3% (n = 1726 patients). Intensive care unit admission was needed in 10.5% (n = 1106 patients), non-invasive mechanical ventilation was required in 8.8% (n = 923 patients), and orotracheal intubation was required in 7.5% (789 patients). DLR presented a c-statistic of 0.69 (95% CI, 0.68-0.71) for in-hospital mortality with an optimal cut-off above 1. Multivariate analysis showed an independent association for in-hospital mortality for DLR > 1 (adjusted OR 2.09, 95% CI 1.09-4.04; p = 0.03); in the same way, survival analysis showed a higher mortality risk for DLR > 1 (HR 2.24; 95% CI 2.03-2.47; p < 0.01). Further, no other laboratory indices showed an independent association for mortality in multivariate analysis.
This study confirmed the usefulness of DLR as a prognostic biomarker for mortality associated with SARS-CoV-2 infection, being an accessible, cost-effective, and easy-to-use biomarker in daily clinical practice.
摘要：
背景：本研究旨在验证D-二聚体与淋巴细胞比率（DLR）在大型国家住院冠状病毒病（COVID-19）患者队列中预测死亡率的作用。
方法：回顾性研究，多中心，纳入西班牙SARS-CoV-2感染住院患者的观察性研究于2020年3月至2022年3月进行.所有分析的生物标志物和实验室指标在入院时测量一次。
结果：本研究共纳入10,575例COVID-19患者。参与者的平均年龄为66.9（±16）岁，其中58.6%(6202例)为男性。总死亡率为16.3%(n=1726例)。10.5%(n=1106例)需要重症监护病房入院，8.8%(n=923例)需要无创机械通气,7.5%(789例患者)需要经口气管插管。DLR对院内死亡率的c统计量为0.69（95％CI，0.68-0.71），最佳临界值高于1。多变量分析显示，DLR>1与住院死亡率存在独立关联（校正OR2.09，95％CI1.09-4.04；p=0.03）；同样，生存分析显示,DLR>1时死亡风险较高(HR2.24;95%CI2.03-2.47;p<0.01).Further,在多变量分析中,没有其他实验室指标显示死亡率的独立相关性.
结论：这项研究证实了DLR作为SARS-CoV-2感染相关死亡率的预后生物标志物的有用性。作为一个无障碍的，成本效益高,和日常临床实践中易于使用的生物标志物。
方法：回顾性研究，多中心，纳入西班牙SARS-CoV-2感染住院患者的观察性研究于2020年3月至2022年3月进行.所有分析的生物标志物和实验室指标在入院时测量一次。
结果：本研究共纳入10,575例COVID-19患者。参与者的平均年龄为66.9（±16）岁，其中58.6%(6202例)为男性。总死亡率为16.3%(n=1726例)。10.5%(n=1106例)需要重症监护病房入院，8.8%(n=923例)需要无创机械通气,7.5%(789例患者)需要经口气管插管。DLR对院内死亡率的c统计量为0.69（95％CI，0.68-0.71），最佳临界值高于1。多变量分析显示，DLR>1与住院死亡率存在独立关联（校正OR2.09，95％CI1.09-4.04；p=0.03）；同样，生存分析显示,DLR>1时死亡风险较高(HR2.24;95%CI2.03-2.47;p<0.01).Further,在多变量分析中,没有其他实验室指标显示死亡率的独立相关性.
结论：这项研究证实了DLR作为SARS-CoV-2感染相关死亡率的预后生物标志物的有用性。作为一个无障碍的，成本效益高,和日常临床实践中易于使用的生物标志物。
