1
|
Chen Z, Nurlan T, Ning F, Zha T, Liu X. Diagnostic Value of Neutrophil CD64 in Burn Patients With Infection in Chinese Population: A Systematic Review and Meta-analysis. J Burn Care Res 2021; 42:1192-1198. [PMID: 33625516 DOI: 10.1093/jbcr/irab033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Infection is one of the leading causes of death in burn patients. Many researchers regard neutrophil CD64 (nCD64) as a biomarker in the early diagnosis of burn patients with infection. Nevertheless, the conclusions are controversial. A comprehensive analysis of the diagnostic value of nCD64 for burn infection was performed in China using a meta-analysis method. Pubmed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and China Wanfang databases were searched for studies on nCD64 as a diagnostic biomarker of burn patients with infection from the establishment of the databases to September 29, 2020. The data were analyzed by Stata 15.0 software. Six studies were identified. The results showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 0.92 (95% confidence interval [CI]: 0.88~0.95), 0.82 (95% CI: 0.76~0.87), 5.10 (95% CI: 3.90~6.80), 0.10 (95% CI: 0.06~0.15), and 52 (95% CI: 29~94), respectively. The area under the curve was 0.94 (95% CI: 0.92~0.94). According to the analysis of the sepsis subgroup, it showed that nCD64 had good diagnostic value in the patients with burn sepsis in Chinese population. Neutrophil CD64 is highly efficient to diagnose burn infection in Chinese population. Therefore, nCD64 could be regarded as a valuable biomarker for the early diagnosis of burn infection in China, especially in patients with burn sepsis. Combined with other diagnostic indexes, nCD64 can be clinically used in the early diagnosis of burn infection to improve the sensitivity and specificity.
Collapse
Affiliation(s)
- Zhao Chen
- Department of Burns, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi City, Xinjiang Uygur Autonomous Region, China
| | - Turxun Nurlan
- Department of Burns, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi City, Xinjiang Uygur Autonomous Region, China
| | - Fangyan Ning
- Intensive Care Unit, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi City, Xinjiang Uygur Autonomous Region, China
| | - Tianjian Zha
- Department of Burns, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi City, Xinjiang Uygur Autonomous Region, China
| | - Xiaolong Liu
- Department of Burns, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi City, Xinjiang Uygur Autonomous Region, China
| |
Collapse
|
2
|
Hu L, Wang B, Hong Y, Xu L, Jiang Y, Wang C, Zhu B, Yu Q, Hou W, Chen Z, Zhu F, Wu G, Sun Y. Admission Neutrophil-Lymphocyte Ratio (NLR) Predicts Survival in Patients with Extensive Burns. Burns 2020; 47:594-600. [PMID: 32893051 DOI: 10.1016/j.burns.2020.07.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Extensive burns is one of the most common severe injuries, with a high annual death rate. Previous studies showed that the neutrophil to lymphocyte ratio (NLR) is a prognostic factor for some inflammatory diseases. However, until now, no study has evaluated the clinical prognostic value of NLR in extensively burned patients. The aim of this study was to investigate the prognostic value of NLR in this medical condition to provide clinical guidance. METHODS 271 patients diagnosed with extensive burns were analysed retrospectively between 2005 and 2018 in the Department of Burn Surgery of Changhai Hospital. NLR cut-off values at the first 3 days of hospitalization were calculated by the ROC analysis. RESULTS Of the 271 patients in this study, the majority (82.3%) were injured by flame. The median total body surface area (TBSA) was 55% (IQR, 40% to 85%) and the median full thickness burn (FTB) was 20% (IQR, 3%-44%). The patients' NLR declined within the first 3 days after admission, and we found that NLR was negatively correlated with the ventilator-free days at day 28 (r = -0.127, P = 0.048). In a multivariate logistic regression analysis, higher admission NLR was independently predictive of higher mortality. According to the ROC curve, the best cut-off values for day 1 (or admission day), day 2 and day 3 NLR were 14, 13 and 7.5, respectively. We then performed a survival analysis, finding that those NLR above the cut-off point had decreased overall survival compared to those with NLR below the cut-off point (p = 0.023, 0.045 and 0.019 for day 1, 2, and 3, respectively). CONCLUSIONS NLR continuously decreased in the first 3 days of hospitalization. Admission NLR above 14 is associated with a decreased survival in patients with extensive burns. These findings demonstrate that NLR has prognostic value in these patients.
Collapse
Affiliation(s)
- Lunyang Hu
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, People's Republic of China.
| | - Baoli Wang
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, People's Republic of China.
| | - Yonggang Hong
- Department of Colorectal Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, People's Republic of China.
| | - Long Xu
- Department of Colorectal Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, People's Republic of China.
| | - Yong Jiang
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, People's Republic of China.
| | - Chen Wang
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, People's Republic of China.
| | - Banghui Zhu
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, People's Republic of China.
| | - Qing Yu
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, People's Republic of China.
| | - Wenjia Hou
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, People's Republic of China.
| | - Zhengli Chen
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, People's Republic of China.
| | - Feng Zhu
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, People's Republic of China.
| | - Guosheng Wu
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, People's Republic of China.
| | - Yu Sun
- Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, People's Republic of China.
| |
Collapse
|