Frequency of In-Hospital Mortality In-Patients Presenting with Acute Heart Failure with Elevated Neutrophil to Lymphocyte Ratio at Tertiary Care Hospital, Karachi

Abstract

Background: Patients admitted with acute heart failure (AHF) have in-hospital mortality rates of great concern, and
a complex cascade of hemodynamic, neurohormonal, and inflammatory responses contribute to this. High NLR in
hospital on admission could indicate the aggravated inflammatory state, which could result in poor clinical outcomes, such as increased in-hospital mortality.
Methodology: A cross-sectional study targeted 135 patients with their admission causes being acute heart failure and elevated NLR ratio. The variables were collected; the age, gender, residence status, diabetes mellitus type II,
hypertension, dyslipidemia, smoking status, obesity status, anemia status, and duration of heart failure. The patients
were monitored and assessed with in-hospital mortality. The control of the effect modifiers was done by stratification
and the post-stratification chi-square test/Fisher test was used with a p-value of 0.05 set as statistically significant.
Results: Mean age of the participants was 55.14 ± 12.49 years, and the mean duration of heart failure was 18.72 ±
10.24 hours. The mean BMI was 27.41 ± 2.56 kg/m², height was 158 ± 7.28 cm, weight was 78.7 ± 9.87 kg, and the
neutrophil-to-lymphocyte ratio (NLR) was 2.21 ± 1.41. Among the participants, 74 (54.81%) were female and 61
(45.19%) were male. In-hospital mortality occurred in 43 (31.9%) patients, while 92 (68.1%) survived during
hospitalization.
Conclusion: NLR is a low-cost, simple-to-use clinical applicable value that forecasts prognosis in the short-term and
classifies the ris