Clinical significance of the platelet-to-neutrophil ratio in patients with the severe abnormal septic encephalopathy
Objective To investigate the diagnostic value of the platelet-to-neutrophil ratio(PNR)in sepsis-associated encephalopathy(SAE).Methods A retrospective analysis was conducted on 111 patients with SAE admitted to the intensive care unit(ICU)of the Department of Intensive Care Medicine,No 908th hospital of the Joint Logistic Support Force of the PLA from March 2019 to September 2021.The patients were divided into the mild abnormal group(n=53)and the severe abnormal group(n=58)according to the electroencephalogram(EEG)grading.Blood routine,coagulation function,and thrombelastogram(TEG)indexes of patients within 2 h of admission were collected,and the risk factors of the severe abnormal SAE were analyzed by Logistic regression.The predictive value of PNR for the severe abnormal SAE was evaluated by the area under the receiver-operating charac-teristic curve(AUC),and the survival curve was drawn by the Kaplan-Meier method.Results Compared with the mild abnormal group of the severe abnormal SAE,the severe abnormal group had significantly higher levels of neutrophil counts,neutrophil-to-lymphocyte ratio(NLR),SOFA score,ICU mortality rate,significantly prolonged prothrombin time(PT),thrombin time(TT),and TEG-K time value,and significantly lower platelet count,PNR,and Glasgow Coma Scale(GCS)score(P<0.05).Univariate and multivariate Logistic regression analysis showed that PT and PNR were independent risk factors for the severe abnormal SAE(P<0.05).The AUC of PNR for diag-nosing the severe abnormal SAE was 0.680(95%CI 0.581～0.680),with a sensitivity of 60.4%and a specificity of 74.15%,and an optimal cut-off value was 25.5.Survival analysis showed a statistically significant difference in the survival rate of the patients in the group of PNR<25.5 versus the group of PNR≥25.5(P<0.05).Conclusion PNR is significantly associated with the risk of the severe abnormal SAE,which can be significantly reduced in patients with the severe abnormal SAE,and patients with sepsis may develop severe abnormal SAE when PNR<25.5.
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