Résumé
Objective:To investigate the relationship between monocyte-to-lymphocyte ratio (MLR) in serum and the all-cause mortality in patients with acute paraquat (PQ) poisoning.Methods:Patients with acute PQ poisoning in the First Affiliated Hospital of Nanchang University from December 2013 to October 2018 were retrospectively selected and followed up until July 1, 2019. The primary endpoint was all-cause mortality. Patients were classified into quartiles based on serum MLR and also dichotomized based on the optimal cutoff at a MLR of 0.61, determined from the receiver operating characteristic (ROC) curve analysis. The Kaplan-Meier curve was used for survival analysis. Multivariate Cox regression analysis was performed to identify risk factors, and ROC curve was applied to analyze the predictive efficacy of MLR in all-cause mortality of acute PQ patients.Results:Of the 117 patients included in the study, 49 (41.88%) patients were male and 68 (58.12%) were female with a mean age of 36.91±16.00 years. The total mortality was 59.8% (70/117). On the Kaplan-Meier analysis, patients in quartile 4 had worse prognosis than patients in quartiles 1, 2 and 3 (Log-rank=33.376, P<0.01), and patients with MLR≥0.61 had a significantly higher all-cause mortality than those with MLR<0.61 (Log-rank=26.451, P<0.01). Cox regression model analysis showed that MLR was an independent predictor of all-cause mortality on the quartile analysis (quartile 4 vs. quartile 1: hazard ratio 2.773, 95% confidence interval ( CI): 1.250 to 6.154, P=0.012). ROC curve showed that the optimal cut-off value of MLR was calculated to be at 0.61, the area under the curve (AUC) was 0.684 (95% CI: 0.591-0.767, P=0.0002), with a sensitivity of 47.14% and a specificity of 91.49%. Conclusions:High MLR was associated with mortality risk in patients with acute PQ poisoning, and MLR may be an effective predictor of all-cause mortality in this population.