Prognostic Value of Lymphocyte-to-White Blood Cell Ratio for In-Hospital Mortality in Infective Endocarditis Patients

Abstract

Background. The prognosis of Infective endocarditis (IE) is poor, and we conducted this investigation to evaluate the worth of admission lymphocyte-to-white blood cell ratio (LWR) for prediction of short-term outcome in IE patients. Methods. We retrospectively assessed the medical records of 147 IE patients from January 2017 to December 2019. Patients were divided into the survivor group and nonsurvivor group. Univariate and multivariate analyses were applied to estimate the independent factors contribution to in-hospital death, and receiver-operator characteristic (ROC) curve was utilized to check the performance. Results. The levels of LWR (0.17 ± 0.08 vs. 0.10 ± 0.06) were significantly increased among the survivor group compared with the nonsurvivor group ( $P$  = 0.001). Multivariate analysis displayed that LWR (hazard ratio (HR): 1.755, 1.304–2.362, $P$  < 0.001) was not interfered by other confounding factors for early death. Moreover, ROC analysis suggested that LWR (cutoff value = 0.10) performed the best among assessed indexes for the forecast of primary outcome (area under curve (AUC) = 0.750, 95% confidence interval (CI) = 0.634–0.867, $P$  < 0.001, sensitivity = 70.0%, specificity = 76.4%), and the proportion of in-hospital mortality was remarkably inferior in patients with LWR > 0.10 than in those with LWR ≤ 0.10. (5.83% vs. 31.8%, $P$  < 0.001). Conclusions. LMR is an independent, simple, universal, inexpensive, and reliable prognostic parameter to identify high-risk IE patients for in-hospital mortality.