Elevated neutrophil-to-lymphocyte ratio (NLR) was independently associated with increased all-cause mortality risk in patients with cor pulmonale, with hazard ratios of 1.58, 1.37, and 1.22 across three adjusted models, supporting NLR as a significant prognostic marker in this population.
Key Findings
Results
Elevated NLR was independently associated with increased risk of adverse outcomes in patients with cor pulmonale across three progressively adjusted multivariate models.
Hazard ratios were 1.58, 1.37, and 1.22 across three adjusted models, all indicating elevated mortality risk in the high-NLR group.
The median NLR value of 8.26 was used as the cutoff to classify patients into low and high NLR groups.
Multivariate models were used to assess the relationship between NLR and mortality risk, controlling for various clinical factors.
The decreasing but consistently elevated hazard ratios across models suggest the association persisted even after progressive adjustment for confounders.
Results
A nonlinear relationship was observed between NLR and all-cause mortality, indicating a complex impact on mortality risk.
A strong correlation was observed between NLR and all-cause mortality.
The nonlinear relationship suggests that the effect of NLR on mortality does not follow a simple linear dose-response pattern.
This finding adds complexity to the interpretation of NLR as a prognostic marker in cor pulmonale patients.
Results
The high-NLR group exhibited significantly worse clinical parameters compared to the low-NLR group.
The high-NLR group had significantly lower albumin levels compared to the low-NLR group.
Poorer kidney function was observed in the high-NLR group.
Unfavourable haematological parameters were present in the high-NLR group.
Patients aged ≥65 years and those with high-risk medical histories were more prevalent in the high-NLR group.
Results
Subgroup analyses confirmed the consistency of the association between elevated NLR and mortality across various patient subgroups.
Subgroup analyses were conducted to validate findings across different populations.
The findings were consistent across various patient subgroups, supporting the generalizability of NLR as a prognostic marker.
The study population included 6681 patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database.
Methods
The study was a retrospective analysis of 6681 cor pulmonale patients from the MIMIC-IV database classified by median NLR.
Data were drawn from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database.
A total of 6681 patients with cor pulmonale were included in the analysis.
Patients were classified into low and high NLR groups based on the median NLR value of 8.26.
Clinical indicators including albumin levels, kidney function, and haematological results were compared between groups.
The study design was retrospective.
What This Means
This research examined whether a simple blood test ratio — the neutrophil-to-lymphocyte ratio (NLR), which reflects inflammation in the body — could predict survival outcomes in patients with cor pulmonale, a serious heart condition caused by chronic lung disease. Using data from over 6,600 intensive care patients, researchers divided patients into two groups based on whether their NLR was above or below the median value of 8.26, then tracked which group had higher rates of death from any cause.
The study found that patients with higher NLR values were significantly more likely to die, with the risk remaining elevated even after accounting for other health factors. Patients in the high-NLR group also tended to have lower protein (albumin) levels in their blood, worse kidney function, and poorer blood counts — all signs of more severe overall illness. Older patients (aged 65 and above) and those with more complex medical histories were also more common in the high-NLR group. Importantly, the relationship between NLR and mortality was not straightforward or linear, suggesting the biological connection is complex.
This research suggests that measuring NLR — a low-cost, routinely available calculation from a standard blood test — could help doctors identify cor pulmonale patients who are at higher risk of dying, potentially allowing for earlier or more intensive intervention. The authors call for further research to better understand how NLR could be practically used to guide treatment decisions in this patient population.
Liu J, Liu X. (2026). The Role of Neutrophil-to-Lymphocyte Ratio in Predicting All-Cause Mortality and Survival Rates in Patients With Cor Pulmonale.. British journal of hospital medicine (London, England : 2005). https://doi.org/10.31083/BJHM56971