The effect of monocyte/HDL-cholesterol ratio on mortality in patients with sepsis in the intensive care unit

THE EFFECT OF MONOCYTE/HDL-CHOLESTEROL RATIO ON MORTALITY IN PATIENTS WITH SEPSIS IN THE INTENSIVE CARE UNIT Purpose: Sepsis is a clinical syndrome that can develop due to many diseases and causes significant morbidity and mortality worldwide. In sepsis patients, predetermination of high-risk patients in terms of mortality is important to reduce mortality. In this study, we aimed to examine the relationship between monocyte/HDL ratio and mortality in sepsis patients. Methods: Fifty sepsis patients followed up for sepsis in our intensive care unit and 50 control patients without sepsis were prospectively analyzed. Hemogram, biochemistry, lactate, SOFA and APACHE II scores of the patients at the time of hospitalization were analyzed in terms of mortality. In addition, similar factors were investigated for possible differences between patients with and without sepsis. Results: 51 of the 100 patients included in the study died at the end of the intensive care unit admission. The median duration of hospitalization in the intensive care unit was calculated as 7 days (4-18). It was observed that patients in the sepsis group died at a significantly higher rate. The median value of the monocyte(103/mL)/HDL (mg/dL) ratio of the patients was calculated as 24.2 (14.3-45.6). The median value of the monocyte/HDL ratio in sepsis patients was 36.2 (17.5-59.3), and the median value was 20.4 (13.5-34.6) in the control group. The higher monocyte/HDL ratio in sepsis patients was found to be statistically significant (p value=0.003). When the hemogram values of the patients were examined in terms of mortality, White blood cells, RDW and neutrophil values were found to be statistically significantly higher in the deceased patients than in the discharged patients. The lymphocyte count was found to be statistically significantly lower in the dead patients. When the biochemistry values of the patients were examined, lactate and urea were found to be statistically significantly higher in the patients who died than in the discharged patients. The median monocyte/HDL value of the patients who died was 34.2 (16.6-61.3), and the median value of the monocyte/HDL ratio of the discharged patients was 19.3 (13.5-35.8). The higher monocyte/HDL ratio in deceased patients was not statistically significant (p value=0.003). When only sepsis patients were evaluated, a statistically significant difference was found between the RDW values of the deceased and discharged patients. When the biochemistry values of the discharged and deceased patients were compared only in the patient group with sepsis, lactate and potassium were found to be statistically different between the two groups. When the patients with sepsis diagnosis who were discharged and died were analysed in terms of acute phase reactants and clinical scoring, SOFA and APACHE II scores were found to be statistically significantly higher in deceased patients. When only sepsis patients were evaluated, the mean monocyte/HDL ratio was calculated as 30.4 (17.9-48.6) in discharged patients and 37.2 (16.6-82.5) in deceased patients. The higher monocyte/HDL ratio in dead patients was not statistically significant (p value=0.039). Conclusion: In our study, when evaluated both in all patients and only in sepsis patients, the monocyte/HDL ratio was found to be more significantly higher in patients with died. In the light of this result, the monocyte/HDL ratio can be used to determine the mortality risk in sepsis patients. However, more work needs to be done to create a general acceptance and consensus on this issue. KEYWORD: Sepsis, monocyte/HDL ratio, mortality in sepsis