Abstract
INTRODUCTION: The 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 METHODS: 3087 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. RESULTS: According 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. CONCLUSIONS: We 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.