Predictive value of peripheral blood platelet to lymphocyte ratio for the survival in elderly patients with diabetic ketoacidosis / 中华老年医学杂志

ABSTRACT

Objective:To investigate the predictive value of peripheral blood platelet to lymphocyte ratio(PLR)for the survival of elderly type 2 diabetes mellitus(T2DM)patients with diabetic ketoacidosis(DKA).Methods:Clinical data of 137 elderly T2DM patients with DKA admitted to our hospital between January 2014 and December 2018 were divided into the survival group(n=109)and the death group(n=28)and retrospectively analyzed.Another 137 elderly T2DM inpatients without DKA during the same period were enrolled as the control group.Clinical data of all patients were recorded to analyze predisposing factors of DKA.Multivariate Logistic regression analysis was used to analyze the related factors for the death in elderly T2DM patients with DKA.The best cut-off value for PLR to predict the survival status of patients was determined.Results:The main predisposing factors for DKA were pulmonary infections and insufficient insulin. Logistic multivariate analysis showed that diastolic blood pressure, Glasgow coma score, the coexisted other organ failure, PLR( OR 3.576, 95% CI2.225~5.472)and mechanical ventilation were risk factors for the survival in elderly T2DM patients with DKA( P<0.05). ROC curve analysis indicated that the area under the curve(AUC)of PLR was 0.803( P=0.002, 95% CI 0.758-0.886). The optimal cut-off value of PLR for prognosis(survival/death)was 224.29, with a sensitivity of 81.7% and a specificity of 70.1%. Conclusions:PLR is easy to obtain and can be used as a sensitive indicator to predict the survival of elderly T2DM patients with DKA.