Lymphocyte-C-reactive protein ratio upon admission to predict disease progression and ICU admission in adult patients with diabetic ketoacidosis
Abstract This study aimed to investigate whether lymphocyte-C-reactive protein ratio (LCR) upon admission can predict disease progression and intensive care unit (ICU) admission in adult patients with diabetic ketoacidosis (DKA). A single-center retrospective study was conducted, including adult DKA...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-024-84054-3 |
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| author | Yi-Jia Hu Shu-Xiao Qiu Jian-Nan Zhang Qi-Qi Lai Yi-Lu Lin Lin-Qiong Liu Di Wu Hui-Ying Liu Huan Meng Jia-Xi Xu Jia-Ning Zhang Bo-Wen Liu Yan Gao Kai Kang Yang Gao |
| author_facet | Yi-Jia Hu Shu-Xiao Qiu Jian-Nan Zhang Qi-Qi Lai Yi-Lu Lin Lin-Qiong Liu Di Wu Hui-Ying Liu Huan Meng Jia-Xi Xu Jia-Ning Zhang Bo-Wen Liu Yan Gao Kai Kang Yang Gao |
| author_sort | Yi-Jia Hu |
| collection | DOAJ |
| description | Abstract This study aimed to investigate whether lymphocyte-C-reactive protein ratio (LCR) upon admission can predict disease progression and intensive care unit (ICU) admission in adult patients with diabetic ketoacidosis (DKA). A single-center retrospective study was conducted, including adult DKA patients admitted to the First Affiliated Hospital of Harbin Medical University between March 2018 and March 2023. Multiple demographic and clinical data were collected from the medical records upon admission and during hospitalization. Subsequently, sequential organ failure assessment (SOFA) score and LCR were calculated based on relevant clinical parameters within 24 h of admission. These indicators were compared among different disease severity groups, and factors related to severe DKA, concurrent acute kidney injury (AKI), and ICU admission were further analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the sensitivity, specificity, area under the ROC curve (AUC), and cut-off value of LCR. A total of 271 adult DKA patients were enrolled and categorized into three groups: mild group (n = 42), moderate group (n = 64), and severe group (n = 165). Significant differences in demographic and clinical data were observed among these groups. Glasgow coma scale (GCS) score, LCR, pH, and bicarbonate (HCO3 -) were identified as protective factors for severe DKA. Conversely, SOFA score, neutrophil count (NEUT), serum creatinine (SCr), and glucose (GLU) were risk factors for concurrent AKI. Concurrent AKI and SOFA score were risk factors for ICU admission, while pH was a protective factor. The areas under the ROC curve (AUC) of LCR to classify adult DKA patients into mild group, severe group, and ICU admission were 0.679, 0.718, and 0.621, respectively, with cut-off value of 212.80, 96.16, and 63.35, sensitivity of 54.8%, 76.4%, and 78.9%, and specificity of 76.0%, 62.4%, and 46.3%. LCR upon admission provides great potential to predict disease progression and ICU admission in adult patients with DKA. |
| format | Article |
| id | doaj-art-33e0ebc4751f4f25af39c0c74882e3c0 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-33e0ebc4751f4f25af39c0c74882e3c02025-01-26T12:29:51ZengNature PortfolioScientific Reports2045-23222025-01-0115111210.1038/s41598-024-84054-3Lymphocyte-C-reactive protein ratio upon admission to predict disease progression and ICU admission in adult patients with diabetic ketoacidosisYi-Jia Hu0Shu-Xiao Qiu1Jian-Nan Zhang2Qi-Qi Lai3Yi-Lu Lin4Lin-Qiong Liu5Di Wu6Hui-Ying Liu7Huan Meng8Jia-Xi Xu9Jia-Ning Zhang10Bo-Wen Liu11Yan Gao12Kai Kang13Yang Gao14Pediatric Surgery Clinic, The Sixth Affiliated Hospital of Harbin Medical UniversityDepartment of Emergency, The Fourth Affiliated Hospital of Harbin Medical UniversityDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical UniversityDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical UniversityDepartment of Critical Care Medicine, The Sixth Affiliated Hospital of Harbin Medical UniversityDepartment of Critical Care Medicine, The Fourth Affiliated Hospital of Harbin Medical UniversityDepartment of Critical Care Medicine, The Sixth Affiliated Hospital of Harbin Medical UniversityDepartment of Critical Care Medicine, The Sixth Affiliated Hospital of Harbin Medical UniversityDepartment of Critical Care Medicine, The Sixth Affiliated Hospital of Harbin Medical UniversityDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical UniversityDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical UniversityDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical UniversityDepartment of Critical Care Medicine, The Fourth Affiliated Hospital of Harbin Medical UniversityDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical UniversityDepartment of Critical Care Medicine, The Sixth Affiliated Hospital of Harbin Medical UniversityAbstract This study aimed to investigate whether lymphocyte-C-reactive protein ratio (LCR) upon admission can predict disease progression and intensive care unit (ICU) admission in adult patients with diabetic ketoacidosis (DKA). A single-center retrospective study was conducted, including adult DKA patients admitted to the First Affiliated Hospital of Harbin Medical University between March 2018 and March 2023. Multiple demographic and clinical data were collected from the medical records upon admission and during hospitalization. Subsequently, sequential organ failure assessment (SOFA) score and LCR were calculated based on relevant clinical parameters within 24 h of admission. These indicators were compared among different disease severity groups, and factors related to severe DKA, concurrent acute kidney injury (AKI), and ICU admission were further analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the sensitivity, specificity, area under the ROC curve (AUC), and cut-off value of LCR. A total of 271 adult DKA patients were enrolled and categorized into three groups: mild group (n = 42), moderate group (n = 64), and severe group (n = 165). Significant differences in demographic and clinical data were observed among these groups. Glasgow coma scale (GCS) score, LCR, pH, and bicarbonate (HCO3 -) were identified as protective factors for severe DKA. Conversely, SOFA score, neutrophil count (NEUT), serum creatinine (SCr), and glucose (GLU) were risk factors for concurrent AKI. Concurrent AKI and SOFA score were risk factors for ICU admission, while pH was a protective factor. The areas under the ROC curve (AUC) of LCR to classify adult DKA patients into mild group, severe group, and ICU admission were 0.679, 0.718, and 0.621, respectively, with cut-off value of 212.80, 96.16, and 63.35, sensitivity of 54.8%, 76.4%, and 78.9%, and specificity of 76.0%, 62.4%, and 46.3%. LCR upon admission provides great potential to predict disease progression and ICU admission in adult patients with DKA.https://doi.org/10.1038/s41598-024-84054-3Lymphocyte-C-reactive protein ratioDiabetic ketoacidosisDisease progressionConcurrent acute kidney injuryIntensive care unit admissionScreening tool |
| spellingShingle | Yi-Jia Hu Shu-Xiao Qiu Jian-Nan Zhang Qi-Qi Lai Yi-Lu Lin Lin-Qiong Liu Di Wu Hui-Ying Liu Huan Meng Jia-Xi Xu Jia-Ning Zhang Bo-Wen Liu Yan Gao Kai Kang Yang Gao Lymphocyte-C-reactive protein ratio upon admission to predict disease progression and ICU admission in adult patients with diabetic ketoacidosis Scientific Reports Lymphocyte-C-reactive protein ratio Diabetic ketoacidosis Disease progression Concurrent acute kidney injury Intensive care unit admission Screening tool |
| title | Lymphocyte-C-reactive protein ratio upon admission to predict disease progression and ICU admission in adult patients with diabetic ketoacidosis |
| title_full | Lymphocyte-C-reactive protein ratio upon admission to predict disease progression and ICU admission in adult patients with diabetic ketoacidosis |
| title_fullStr | Lymphocyte-C-reactive protein ratio upon admission to predict disease progression and ICU admission in adult patients with diabetic ketoacidosis |
| title_full_unstemmed | Lymphocyte-C-reactive protein ratio upon admission to predict disease progression and ICU admission in adult patients with diabetic ketoacidosis |
| title_short | Lymphocyte-C-reactive protein ratio upon admission to predict disease progression and ICU admission in adult patients with diabetic ketoacidosis |
| title_sort | lymphocyte c reactive protein ratio upon admission to predict disease progression and icu admission in adult patients with diabetic ketoacidosis |
| topic | Lymphocyte-C-reactive protein ratio Diabetic ketoacidosis Disease progression Concurrent acute kidney injury Intensive care unit admission Screening tool |
| url | https://doi.org/10.1038/s41598-024-84054-3 |
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