Correlation analysis was carried between neutrophils, lymphocytes, monocytes, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), NT-proBNP, MHR, NHR, LHR and PESI score, the results are shown in Table 1. In the study population, 80 (37%) patients suffered the adverse events. Demographic and laboratory characteristics of event group and non-event group are summarized in Table 2. Significant differences were observed in terms of white blood cells (WBC), neutrophils, monocytes, total cholesterol (TC), HDL-C, ALT, AST, creatinine, fibrinogen degradation products (FDP), D-Dimer, Troponin-I (TNI), N-terminal pro-brain natriuretic peptide (NT-proBNP), MHR, NHR and PESI scores.
Table 1
Correlation analysis with PESI score HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; NT-proBNP, N-terminal pro-brain natriuretic peptide; MHR, monocyte to HDL-C ratio; NHR, neutrophil to HDL-C ratio; LHR, lymphocyte to HDL-C ratio; PESI, Pulmonary Embolism Severity Index
Item
|
neutrophil
|
monocyte
|
lymphocyte
|
HDL-C
|
LDL-C
|
NT-proBNP
|
MHR
|
NHR
|
LHR
|
PESI
|
P value
|
< 0.01
|
< 0.01
|
< 0.01
|
< 0.01
|
< 0.01
|
< 0.01
|
< 0.01
|
< 0.01
|
< 0.01
|
|
correlation
|
0.371
|
0.254
|
-0.272
|
-0.256
|
-0.206
|
0.438
|
0.353
|
0.427
|
-0.137
|
Table 2
Comparison of demographic and laboratory tests between event group and non-event group.
ITEM
|
Not Event group(N = 135)
|
Event group
(N = 80)
|
P value
|
Demographic dates
|
Age (years)
|
72(62–80)
|
72(55.25–77.75)
|
0.191
|
BMI (kg/m2)
|
24.80(23.50–26.70)
|
24.54(23.15–26.70)
|
0.545
|
Male
|
81(60%)
|
37(46%)
|
0.05
|
Smoking
|
8(5%)
|
9(11%)
|
0.119
|
Drink
|
7(5%)
|
9(11%)
|
0.073
|
Hypertension
|
75(56%)
|
47(59%)
|
0.648
|
Diabetes
|
19(14%)
|
11(14%)
|
0.947
|
DVT
|
83(62%)
|
48(60%)
|
0.803
|
Laboratory tests
|
WBC,109/L
|
6.54(5.48–7.76)
|
8.22(6.46–11.68)
|
< 0.01
|
PLT,109/L
|
191(149–225)
|
191(131-222.5)
|
0.467
|
Neutrophil,109/L
|
4.37(3.37–5.61)
|
5.97(4.56–8.93)
|
< 0.01
|
Lymphocyte,109/L
|
1.49(1.1–1.78)
|
1.215(0.835–1.91)
|
0.178
|
Monocyte,109/L
|
0.39(0.32–0.48)
|
0.51(0.395–0.69)
|
< 0.01
|
Albumin
|
37.8(33.9–40.8)
|
35.1(31.4–39.2)
|
< 0.01
|
Globulin
|
26.8(24.0-30.5)
|
27(23.8–31.5)
|
0.62
|
TC, mmol/L
|
4.55(3.73–5.17)
|
3.95(3.04–4.64)
|
< 0.01
|
HDL-C, mmol/L
|
1.19(1-1.36)
|
0.92(0.79–1.06)
|
< 0.01
|
LDL-C, mmol/L
|
2.64(2.16–3.26)
|
2.48(1.81–2.92)
|
0.423
|
ALT, U/L
|
18(13–30)
|
26.5(20.5–45.5)
|
< 0.01
|
AST, U/L
|
21(17–27)
|
28(21–46)
|
< 0.01
|
Creatinine, mmol/L
|
73(58–87)
|
80.5(63.5–103)
|
0.03
|
FDP, mg/L
|
16.25(9.31–27.4)
|
21.95(13.235–45.86)
|
< 0.01
|
D-dimer, mg/L
|
2.75(1.78–4.81)
|
3.55(2.20–7.33)
|
< 0.01
|
TNI, ng/ml
|
0.01(0.01–0.03)
|
0.02(0.01–0.16)
|
< 0.01
|
NT-proBNP, pg/ml
|
400(222–1090)
|
1400(400–6292)
|
< 0.01
|
MHR
|
0.34(0.26–0.44)
|
0.54(0.42–0.73)
|
< 0.01
|
NHR
|
3.87(2.77–4.87)
|
6.7(4.67–9.67)
|
< 0.01
|
LHR
|
1.26(0.88–1.65)
|
1.35(0.79–2.14)
|
0.367
|
PESI
|
81(70–97)
|
127.5(98-146.5)
|
< 0.01
|
DVT, Deep vein thrombosis; WBC, white blood cell count; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; FDP, fibrinogen degradation products; TNI, Troponin-I; NT-proBNP, N-terminal pro-brain natriuretic peptide; MHR, monocyte to HDL-C ratio; NHR, neutrophil to HDL-C ratio; LHR, lymphocyte to HDL-C ratio; PESI, Pulmonary Embolism Severity Index |
In univariate regression analysis, WBC, neutrophils, monocyte, ALT, AST, TC, HDL-C, creatinine, FDP, DD, NT-proBNP, MHR, NHR, and PESI scores are correlated with PEACE. WBC, neutrophil, monocyte, TC and HDL-C were not included in the regression analysis to avoid multicollinearity [17]. It was found that PESI scores (OR: 1.041 95% CI: 1.024 ~ 1.059, p < 0.01), MHR value (OR: 1.053 95% CI: 3.25–52.64, p < 0.01), NHR value (OR: 1.332 95% CI: 1.020 ~ 1.740, p = 0.035), and Nt-proBNP (OR: 1.203 95% CI: 1.036 ~ 1.397, P = 0.015) were independent predictors of PEACE in the study population (Table 3).
Table 3. Univariate and multivariate regression analysis of PEACE in the study population.
ITEM
|
Univariate analysis
|
Multivariate analysis
|
P
|
OR(95%CI)
|
P
|
OR(95%CI)
|
WBC,109/L
|
< 0.01
|
1.393(1.231 ~ 1.577)
|
|
|
Neurophil,109/L
|
< 0.01
|
1.576(1.342 ~ 1.851)
|
|
|
Monocyte,109/L
|
< 0.01
|
129.362(19.106 ~ 875.885)
|
|
|
Albumin
|
< 0.01
|
0.911(0.857 ~ 0.968)
|
|
|
TC, mmol/L
|
< 0.01
|
0.574(0.429 ~ 0.768)
|
|
|
HDL-C mmol/L
|
< 0.01
|
0.032(0.009 ~ 0.118)
|
|
|
ALT, U/L
|
< 0.01
|
1.015(1.005 ~ 1.025)
|
|
|
AST, U/L
|
< 0.01
|
1.032(1.008 ~ 1.036)
|
|
|
Creatinine, mmol/L
|
< 0.01
|
1.012(1.003 ~ 1.022)
|
|
|
FDP, mg/L
|
< 0.01
|
1.020(1.008 ~ 1.032)
|
|
|
D-dimer, mg /L
|
0.031
|
1.053(1.005 ~ 1.105)
|
|
|
NT-proBNP,103 pg/ml
|
< 0.01
|
1.331(1.165 ~ 1.522)
|
0.015
|
1.203(1.036 ~ 1.397)
|
MHR (%) *
|
< 0.01
|
1.075(1.051 ~ 1.099)
|
< 0.01
|
1.053(1.017 ~ 1.090)
|
LHR
|
0.056
|
1.373(0.991 ~ 1.902)
|
|
|
NHR
|
< 0.01
|
1.791(1.493 ~ 2.148)
|
0.035
|
1.332(1.020 ~ 1.740)
|
PESI
|
< 0.01
|
1.048(1.035 ~ 1.062)
|
< 0.01
|
1.041(1.024 ~ 1.059)
|
WBC, white blood cell count; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; FDP, fibrinogen degradation products; TNI, Troponin-I; NT-proBNP, N-terminal pro-brain natriuretic peptide; MHR, monocyte to HDL-C ratio; NHR, neutrophil to HDL-C ratio; LHR, lymphocyte to HDL-C ratio; PESI, Pulmonary Embolism Severity Index; *The MHR value in this study is small, resulting in excessive OR value. Therefore, MHR in regression analysis is expressed as a percentage.
In ROC analysis for PEACE, significant efficacy of MHR, NHR, NT-proBNP and PESI were observed in predicting PEACE (Table 4). The area under ROC curve for MHR value was 0.810 (95%CL 0.750 ~ 0.869, P < 0.01), and when MHR value was taken as 0.40, it has 80% sensitivity and 70% specificity in predicting PEACE. The area under ROC curve for NHR value was 0.813 (95%CL, 0.752 ~ 0.874 P < 0.01), and when NHR value was taken as 4.95, it has 74% sensitivity and 70% specificity in predicting PEACE. It was found that the area under the ROC curve for the PESI value was 0.838 (95%CL 0.782 ~ 0.894, P < 0.01) and NT-proBNP was 0.697 (95%CL 0.620 ~ 0.774, P < 0.01) (Fig. 1).
Table 4
The area under the curve for NHR, MHR, Nt-proBNP and PESI.
Item
|
Area under curve
|
95% CI
|
P value
|
PESI
|
0.838
|
0.782 ~ 0.894
|
< 0.01
|
NT-proBNP
|
0.697
|
0.620 ~ 0.774
|
< 0.01
|
MHR
|
0.810
|
0.750 ~ 0.869
|
< 0.01
|
NHR
|
0.813
|
0.752 ~ 0.874
|
< 0.01
|
PESI, Pulmonary Embolism Severity Index; N-terminal pro-brain natriuretic peptide; MHR, monocyte to HDL-C ratio; NHR, neutrophil to HDL-C ratio; |