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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1507992

Association between D-dimer to lymphocyte ratio and in hospital all-cause mortality in elderly patients with sepsis: a cohort of 1123 patients

Provisionally accepted
Xinguang Long Xinguang Long 1Zhenkui Hu Zhenkui Hu 2Chao Song Chao Song 2jinhui zhang jinhui zhang 2*
  • 1 Yangzhong People's Hospital, zhenjiang, China
  • 2 Jiangsu University, Zhenjiang, China

The final, formatted version of the article will be published soon.

    The D-dimer to lymphocyte ratio (DLR), a novel inflammatory biomarker, had been shown to be related to adverse outcomes in patients with various diseases. However, there was limited research on the relationship between the DLR and adverse outcomes in patients with infectious diseases, particularly those with sepsis. Therefore, this study aimed to explore the association between the DLR and in hospital all-cause mortality in elderly patients with sepsis.Methods: A total of 1123 patients admitted in intensive care unit (ICU) were included in this study. The patients were categorized into quartiles (Q1-Q4) based on their DLR values. The primary outcomes included hospital mortality and ICU mortality.Kaplan-Meier analysis was conducted to compare all-cause mortality among the four DLR groups. The association between DLR and all-cause mortality in patients with sepsis was further elucidated using the receiver operating characteristic (ROC) curve and Cox proportional hazards regression analysis.The study included participants with a median age of 75 (65-84) years, with 707 (63.0%) being male. The rates of hospital mortality and ICU mortality were 33.7% and 31.9%, respectively. Kaplan-Meier analysis highlighted a significantly 2 increased risk of all-cause mortality among patients with elevated DLR values (log-rank p < 0.001). ROC curve analyses revealed that DLR had a stronger ability to predict hospital mortality and ICU mortality in patients with sepsis than D-dimer or Lym. Multivariable Cox proportional hazards analyses revealed DLR as an independent predictor of hospital death [per 1 SD increase in DLR: HR (95% CI):1.098 (1.020-1.181); p = 0.013] and ICU death [per 1 SD increase in DLR: HR (95% CI): 1.095 (1.017-1.180); p = 0.017] during the hospital stay.Conclusions: A higher DLR value was associated with hospital and ICU all-cause death in elderly patients with sepsis. This finding demonstrated that the DLR could be a convenient and useful prognostic marker for sepsis prognosis.

    Keywords: Sepsis, d-dimer, lymphocyte, D-dimer to lymphocyte ratio, All-cause mortality

    Received: 08 Oct 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 Long, Hu, Song and zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: jinhui zhang, Jiangsu University, Zhenjiang, China

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