Correlation of Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios With in-Hospital Mortality in Patient Acute Decompensated Heart Failure

Background: Acute Decompensated Heart Failure (ADHF) is a leading cause of hospitalization among heart failure (HF) patients, contributing to high rates of morbidity and mortality. In such acute decompensated conditions, the body's innate immune system is activated, leading to oxidative stress and the release of proinflammatory cytokines. The Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) are emerging as cost-effective, easily measurable markers of inflammation that could act as potential prognostic indicators. Objectives: The goal of this study was to evaluate the association between NLR and PLR with in-hospital mortality in patients with ADHF. Methods: A cross-sectional study was carried out involving 69 ADHF patients who visited the Emergency Department of Muhammadiyah Lamongan Hospital between January 1 and June 30, 2021. NLR and PLR values were recorded at the time of admission. Pearson's correlation test was applied to assess the relationship between NLR, PLR, and in-hospital mortality. The cut-off values were established using the Receiver Operating Characteristic (ROC) curve. Results: This study shows that NLR (12.7±9.1 vs 6.8±3.4; r=0.418; p=0.001) and PLR (336.9±214.8 vs 205.4±78.5; r=0.402; p=0.001) values are higher in patients who died in the hospital compared to those who survived and have a statistically significant correlation with hospital mortality. The cut-off value for NLR was 8.33 (sensitivity 67.9%, specificity 68.3%, AUC 73.1%), while the cut-off for PLR was 216 (sensitivity 60.7%, specificity 58.5%, AUC 67%). Conclusion: Increased NLR and PLR values are strongly linked to in-hospital mortality and could act as straightforward, dependable prognostic indicators in ADHF patients