NLR predicts survival in polymyositis, dermatomyositis
In patients with polymyositis or dermatomyositis, a high peripheral blood neutrophil-to-lymphocyte ratio (NLR) is independently associated with poorer overall survival, according to a study.
The researchers retrospectively reviewed the medical records of 197 patients (mean age at diagnosis 50.3±14.0 years; 65.0 percent female) with newly diagnosed polymyositis/dermatomyositis and recorded 26 deaths over the mean follow-up period of 33.6±33.9 months. The 5-year survival rate was 82 percent.
The log-transformed NLR and C-reactive protein-to-albumin ratio (CAR) were significantly higher in nonsurvivors (2.002±0.684 and –0.687±1.934, respectively) than in survivors (1.266±0.822 and s-2.403±2.244, respectively; p<0.001 for both).
Receiver operating curve (ROC) analysis showed that the optimal cutoff values for NLR and CAR were 4.775 and 0.0735, respectively. The corresponding mean areas under the ROC (AUC) for predicting mortality were 0.778 and 0.714.
Participants who were categorized into the high NLR and CAR groups according to the above cutoff values had significantly lower survival than their counterparts in the low NLR and CAR groups (p<0.001 for both).
In a subsequent multivariate analysis, adjusted for covariates through forward selection, both log-transformed (hazard ratio [HR], 2.216; 95 percent CI, 1.176–3.843; p<0.05) and elevated (HR, 5.201; 1.923–14.068; p=0.001) NLR were significant and independent predictors of lower overall mortality. Notably, the statistical relationship of CAR to survival was attenuated.
Other significant predictors included age >50 years (HR, 4.507; 1.289–15.733; p=0.018), hypoproteinemia (HR, 3.586; 1.333–9.650; p=0.01), and the presence of acute interstitial pneumonia (HR, 14.433; 6.076–34.286; p<0.001).