（中性粒细胞 + 单核细胞/淋巴细胞比值对心力衰竭患者住院死亡的预测价值研究

Background Heart failure（HF） is known to be one of the major problems in the cardiovascular field needed to be urgently addressed due to its high incidence，high mortality and poor prognosis. Searching for the optimal risk assessment method is currently a priority effort in this field. Recent studies have identified inflammation as one of the important pathophysiological mechanisms in the development and progress of HF，the detection and evaluation of multiple inflammatory indicators may be an important method to predict the regression of HF，therefore，exploration of simple and easy-to-perform inflammatory predictors with the optimal comprehensive performance is becoming a focus of attention. Objective To explore the predictive value of（neutrophil + monocyte）/lymphocyte ratio（NMLR） in peripheral blood on the in-hospital mortality of HF patients. Methods A total of 583 patients with HF admitted to Puyang Oilfield General Hospital from January 2020 to September 2022 were collected and divided into the survival group（n=564） and the death group（n=19） according to the occurrence of all-cause death during hospitalization. The baseline data was collected including demographic characteristic，complications，primary disease and laboratory test results；multivariate Cox analysis was used to explore the influencing factors of in-hospital mortality in HF patients；restrictive cubic spline（RCS） was used to determine the relationship between NMLR and in-hospital mortality in HF patients；receiver operating characteristic（ROC） curve was plotted to explore the predictive value of NMLR for in-hospital mortality of HF patients and calculate the optimal cut-off value；Kaplan-Meier method was used to plot the survival curves of patients with different NMLR values. Results The NMLR at admission in the death group〔8.36（3.15，9.55）〕was higher than that in the survival group〔5.00（3.23，8.72）〕（P<0.05），The results of multivariate Cox proportional hazards regression model showed that NMLR was the influencing factor of in-hospital mortality in HF patients〔HR=1.003，95%CI（1.001，1.005），P<0.05〕；the area under ROC curve for NMLR to predict in-hospital mortality of HF patients was 0.704〔95%CI（0.652，0.757）〕，with the optimal cut-off value of 7.93. The RCS showed a non-linear positive correlation between the NMLR value and the risk of in-hospital mortality in patients with HF（P<0.05）. The in-hospital survival was lower in patients with NMLR ≥ 7.93 than those with NMLR<7.93（χ²=111.843，P<0.001）. Conclusion The elevated NMLR value at admission maybe an independent predictor of in-hospital mortality in HF patients.