Can NLR, PLR and LMR be used as prognostic indicators in patients with pulmonary embolism? A commentary
Open Access
- 6 November 2020
- journal article
- editorial
- Published by Association of Basic Medical Sciences of FBIH in Bosnian Journal of Basic Medical Sciences
- Vol. 21 (4), 501
- https://doi.org/10.17305/bjbms.2020.5236
Abstract
We read with great interest the article “Prognostic role of NLR, PLR, and LMR in patients with pulmonary embolism” by Köse et al.[1]. They found that the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) were related to the prognosis and clinical severity of patients with pulmonary embolism (PE). First of all, we congratulate the authors for their invaluable contribution to literature. However, we think that there are some points that should be discussed regarding the use of these laboratory parameters. White blood cell subtypes NLR, PLR, and LMR have been associated with many inflammatory diseases, including PE [2,3]. These parameters, which can be easily determined by simple and easy measurement of systemic inflammation, maintain their importance today. However, these parameters are affected by many factors such as trauma, local or systemic infection, acute coronary syndromes, and malignancy [3-5]. For these reasons, it would be better for the authors to mention these factors and exclude them from the tables that included malignancy and trauma patients in the study. It is known that drugs including steroids can increase neutrophils and decrease lymphocytes and therefore affect NLR, PLR and LMR values [6]. Therefore, it will be more valuable to exclude patients who use drugs that may affect laboratory parameters. In addition, plasma inflammatory biomarkers are time dependent variables, the time of sample collection and the time from the onset of the symptom to the sampling may have an impact on the parameters [3-6]. Therefore, it is important to identify the time from first symptom to sample collection and the factors that may affect it. In conclusion, because NLR, PLR and LMR can be affected by many factors, prospective studies with large populations are needed to show the accuracy of use in critically ill patients.Keywords
This publication has 4 references indexed in Scilit:
- Prognostic role of NLR, PLR, and LMR in patients with pulmonary embolismBosnian Journal of Basic Medical Sciences, 2019
- Prognostic value of the neutrophil‑lymphocyte, platelet‑lymphocyte and monocyte‑lymphocyte ratio in breast cancer patientsOncology Letters, 2019
- Association of Platelet to Lymphocyte and Neutrophil to Lymphocyte Ratios with In-Hospital Mortality in Patients with Type A Acute Aortic DissectionBrazilian Journal of Cardiovascular Surgery, 2019
- Value of Early Risk Stratification Using Hemoglobin Level and Neutrophil-to-Lymphocyte Ratio in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary InterventionThe American Journal of Cardiology, 2011