Predictive value of baseline CRP, NLR, and LER for aspiration pneumonia in patients with acute cerebral infarction / 中华急诊医学杂志

ABSTRACT

Objective:To investigate the predictive value of C-reactive protein (CRP), neutrophils-lymphocytes ratio (NLR) and leukocyte-erythrocyte ratio (LER) for aspiration pneumonia (AP) in patients with acute cerebral infarction (ACI).Methods:Retrospective analysis was performed on 989 consecutive hospitalized ACI patients in 2021 who were free of infection within 48 h after ACI onset. General information, past medical history, CRP and complete blood count within 24 h after admission were collected. NLR and LER were calculated based on neutrophil, lymphocyte, leukocyte and erythrocyte count. ACI patients were divided into two groups non-AP group ( n = 883) and AP group ( n = 106) according to whether they had AP 48 h after admission. Spearman correlations of CRP, NLR and LER with AP were analyzed. The receiver operator characteristic (ROC) curves were plotted to evaluate the predictive values of CRP, NLR and LER for the occurrence of AP in ACI patients, and the sensitivity and specificity at the optimal cut-off value were also calculated. Logistic regression analysis was used for further verification. Results:Compared with the non-AP group, CRP, NLR and LER were significantly higher in the AP group ( P<0.05). Spearman correlation analysis showed that AP was positively correlated with CRP, NLR and LER ( r = 0.42, 0.36 and 0.35, P<0.01). ROC curve analysis showed that CRP, NLR and LER had certain predictive value for AP in ACI patients ( P<0.05), and the area under the curve (AUC) was 0.8917, 0.8349 and 0.8269, respectively. The optimal cutoff values of CRP, NLR and LER were 12.70 mg/L, 4.40 and 1.89 ×10 -3, respectively, with the sensitivity and specificity of 79.25% and 86.41%, 71.70% and 84.94%, and 75.47% and 79.95%, respectively. Multivariate Logistic regression analysis showed that CRP ( OR=6.65, 95% CI 3.70-11.98, β=1.90, P<0.001), NLR ( OR=2.84,95% CI 1.60-5.03, β=1.04, P<0.001) and LER ( OR=3.51, 95% CI 2.00-6.16, β=1.26, P<0.001) were independent risk factors for AP in ACI patients. Conclusions:CRP, NLR and LER at baseline show certain predictive value for the occurrence of AP in ACI patients, and CRP has the strongest predictive power.