High glucose-to-lymphocyte ratio associated with poor prognosis in patients with sepsis-associated AKI

This study was published in the journal Zhonghua Wei Zhong Bing Ji Jiu Yi Xue by Zhang L. and colleagues. The study aimed to evaluate whether GLR levels could serve as a predictor of patient outcomes in this critical medical condition. The study examined 1,524 SA-AKI patients, aged 18 years and above, utilizing the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Patients were categorized into three groups based on GLR levels: GLR1 (≤ 4.97×10[-9] mmol), GLR2 (4.97×10[-9] mmol < GLR < 9.75×10[-9] mmol), and GLR3 (≥ 9.75×10[-9] mmol). The study assessed mortality rates at 28 days, 90 days, 180 days, and 1 year among the patient groups. Additionally, multivariate logistic regression analysis and receiver operator characteristic curve (ROC curve) analysis were employed to determine GLR's predictive efficacy for 28-day mortality.

• Mortality Rates: Mortality rates, at various time points, increased incrementally with higher GLR levels. For instance, at 28 days, mortality was 11.64%, 22.00%, and 33.86% in GLR1, GLR2, and GLR3 groups, respectively.

• Association with Mortality: The GLR demonstrated a direct association with mortality, as higher GLR levels were significantly linked to increased mortality rates within 28 days.

• Predictive Value: The area under the ROC curve (AUC) for GLR in predicting 28-day mortality was 0.674, indicating moderate predictive ability. When combined with acute physiology score III (APS III) and sequential organ failure assessment (SOFA) score, the predictive performance improved substantially, with an AUC of 0.806.

The findings highlight the importance of assessing GLR alongside other established scores (APS III, SOFA) for a more accurate prediction of mortality risk in SA-AKI patients. This extensive investigation provides clinicians with a novel insight into utilizing GLR as a potential prognostic indicator in the assessment and management of SA-AKI patients, potentially aiding in tailored interventions and improved patient outcomes.

Reference:

Zhang, L., Liu, F., Li, Q., Li, Y., Shao, Q., Tao, W., Hu, P., Qian, K., & Lu, Y. (2023). Association between blood glucose-to-lymphocyte ratio and prognosis of patients with sepsis-associated acute kidney injury. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 35(12). https://doi.org/10.3760/cma.j.cn121430-20230901-00725