Prognostic Value of Platelet to Lymphocyte Ratio in Sepsis: A Systematic Review and Meta-analysis

The goal of this study was to conduct a systematic review of the literature on the relationship between peripheral blood platelet to lymphocyte ratio (PLR) and mortality in sepsis and to integrate the findings in a meta-analysis. An electronic search of three main databases was performed: PubMed, Embase, and Scopus on 19 December 2021. Finally, 16 studies comprising 2403 septic patients, including 1249 survivors and 1154 nonsurvivors, were included in this meta-analysis. We found that PLR levels were significantly higher in nonsurvivors than in survivors (random effect model: SMD=0.72, 95% CI; 0.35-1.10, p < 0.001). However, significant heterogeneity was observed across the studies (I2=94.1%, p < 0.01). So, we used random effect model in our meta-analysis. In the subgroup analysis, according to mortality time, patients deceased during one month after sepsis had elevated levels of PLR compared to survivors (SMD=1.03, 95% CI=0.15-1.92, p=0.22). However, in-hospital mortality was not associated with PLR level (SMD=0.41, 95% CI=-0.18-0.99, p=0.175). Our findings support PLR to be a promising biomarker that can be readily integrated into clinical settings to aid in the prediction and prevention of sepsis mortality.

Automated summary

This study found that septic patients with higher PLR levels had a significantly higher mortality rate, indicating that PLR could serve as a promising biomarker for predicting and preventing sepsis mortality.