A comparison of the predictive validity of the combination of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and other risk scoring systems for intravenous immunoglobulin ivig-resistance in Kawasaki diseaseReport as inadecuate




A comparison of the predictive validity of the combination of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and other risk scoring systems for intravenous immunoglobulin ivig-resistance in Kawasaki disease - Download this document for free, or read online. Document in PDF available to download.

Background

We recently reported that the combination of the neutrophil-to-lymphocyte ratio NLR and the platelet-to-lymphocyte ratio PLR is a novel and useful predictor of intravenous immunoglobulin IVIG-resistance in Kawasaki disease KD. In the present study, to evaluate the effectiveness of the new risk score, we compared its predictive validity to that of previously reported risk scores.

Materials and methods

The laboratory records of 437 patients with KD before IVIG therapy were retrospectively analyzed, and the IVIG-responsive n = 344 and IVIG-resistant n = 93 patients were compared. The validity of the new score the combination of NLR≥3.83 and PLR≥150 for predicting IVIG resistance in KD was compared to that of the Kobayashi, Egami and Sano risk scores.

Results

The new score and the Kobayashi score displayed high sensitivity 0.72 and 0.70 respectively and specificity 0.67 and 0.68 respectively, while the Egami and Sano scores showed high specificity 0.71 and 0.81 respectively but relatively low sensitivity 0.56 and 0.45 respectively. The odds ratios ORs for the new score, the Kobayashi score, the Egami score and the Sano score were 5.34 95% confidence interval CI 3.22–8.85, 4.87 95% CI 2.96–8.01, 3.14 95% CI 1.96–5.03 and 3.53 95% CI 2.17–5.77 respectively.

Conclusions

The predictive validity of the combination of NLR≥3.83 and PLR≥150, which is a simple and convenient indicator, was equal to or higher than that of the other risk scores. This suggests that the new score could be a widely available marker for predicting IVIG resistance in KD.



Author: Seiichiro Takeshita , Takashi Kanai, Yoichi Kawamura, Yusuke Yoshida, Shigeaki Nonoyama

Source: http://plos.srce.hr/



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