[논문]약물중독 환자에서 Neutrophil Lymphocyte Ratio의 흡인성폐렴 발생 예측인자로서의 고찰

이정범; 이선화; 윤성종; 류석용; 최승운; 김혜진; 강태경; 오성찬; 조석진; 서범석

doi:10.22537/jksct.16.2.61

약물중독 환자에서 Neutrophil Lymphocyte Ratio의 흡인성폐렴 발생 예측인자로서의 고찰
Neutrophil-to-lymphocyte Ratio as A Predictor of Aspiration Pneumonia in Drug Intoxication Patients 원문보기

대한임상독성학회지 = Journal of the Korean society of clinical toxicology, v.16 no.2, 2018년, pp.61 - 67

이정범 (인제대학교 상계백병원 응급의학과) , 이선화 (인제대학교 상계백병원 응급의학과) , 윤성종 (경희대학교 강동경희대병원 영상의학과) , 류석용 (인제대학교 상계백병원 응급의학과) , 최승운 (인제대학교 상계백병원 응급의학과) , 김혜진 (인제대학교 상계백병원 응급의학과) , 강태경 (인제대학교 상계백병원 응급의학과) , 오성찬 (인제대학교 상계백병원 응급의학과) , 조석진 (인제대학교 상계백병원 응급의학과) , 서범석 (을지대학교 노원을지병원 응급의학과)

Abstract ▼ AI-Helper

Purpose: To evaluate the association between neutrophil-to-lymphocyte ratio (NLR) and occurrence of aspiration pneumonia in drug intoxication (DI) patients in the emergency department (ED) and to evaluate the relationship between NLR and length of hospital admission/intensive care unit (ICU) admission Methods: A total of 466 patients diagnosed with DI in the ED from January 2016 to December 2017 were included in the analysis. The clinical and laboratory results, including NLR, were evaluated as variables. NLR was calculated as the absolute neutrophil count/absolute lymphocyte count. To evaluate the prognosis of DI, data on the development of aspiration pneumonia were obtained. Also, we evaluated the relationship between NLR and length of hospital admission and between NLR and length of ICU admission. Statistically, multivariate logistic regression analyses, receiver-operating characteristic (ROC) curve analysis, and Pearson's correlation (${\rho}$) were performed. Results: Among the 466 DI patients, 86 (18.5%) developed aspiration pneumonia. Multivariate logistic regression analysis revealed NLR as an independent factor in predicting aspiration pneumonia (odds ratio, 1.7; p=0.001). NLR showed excellent predictive performance for aspiration pneumonia (areas under the ROC curves, 0.815; cut-off value, 3.47; p<0.001) with a sensitivity of 86.0% and a specificity of 72.6%. No correlations between NLR and length of hospital admission (${\rho}=0.195$) and between NLR and length of ICU admission (${\rho}=0.092$) were observed. Conclusion: The NLR is a simple and effective marker for predicting the occurrence of aspiration pneumonia in DI patients. Emergency physicians should be alert for aspiration pneumonia in DI patients with high NLR value (>3.47).

주제어

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문제 정의

However, to the best of our knowledge, no study has evaluated the accuracy of NLR as a predictive marker for aspiration pneumonia in DI patients in the ED. Therefore, in this study, we aimed to evaluate the association between NLR and the occurrence of aspiration pneumonia in DI patients in the ED.
Studies that predict the occurrence of aspiration pneumonia in DI patients are limited. To the best of our knowledge, this is the first study to evaluate the predictive performance of NLR for the occurrence of aspiration pneumonia. In this present study, we demonstrated that NLR has a high predictive performance for the occurrence aspiration pneumonia in DI patients.

제안 방법

Three factors were evaluated statistically. First, multivariate logistic regression analysis was performed to determine independent factors for the development of the aspiration pneumonia in DI patients. Variables found to be statistically significant on univariate analysis were entered into the multivariate logistic regression analysis.
The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were generated from multivariate analyses. Second, a receiver operating characteristic (ROC) curve analysis (including cut-off values for optimal area under the curve (AUC), sensitivity, and specificity) was performed to identify the diagnostic performance of the independent significant variables for the prediction of aspiration pneumonia. Third, the correlation coefficient (ρ, rho) between NLR and length of hospital admission and between NLR and length of ICU admission was calculated using Pearson’s correlation.

대상 데이터

A total of 466 DI patients were enrolled in the study. The baseline characteristics of the patients are presented in Table 1.
If the patient was discharged after prompt treatment, the chest radiograph or chest CT findings were used on their follow-up visits. Both radiographs and CT images were interpreted by a board-certified radiologist.
Patients were recruited from January 2016 to December 2017 in a tertiary university teaching hospital that accommodates approximately 65,000 patients in the ED annually. The criteria for inclusion were as follows: 1) age 18 years or older and 2) visited the ED complaining of DI.

데이터처리

Third, the correlation coefficient (ρ, rho) between NLR and length of hospital admission and between NLR and length of ICU admission was calculated using Pearson’s correlation.

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저자의 다른 논문 :

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