The role of neutrophil to platelet ratio in predicting death in elderly patients with ST-elevation myocardial infarction receiving percutaneous coronary intervention

Background Despite receiving percutaneous coronary intervention(PCI),the mortality in elderly patients with ST-segment elevation myocardial infarction(STEMI)remains high.The aim of this study was to explore the prognostic value of neutrophil to platelet ratio(NPR)in elderly STEMI patients receiving PCI.Methods Patients≥65 years old with the diagnosis of STEMI who had received PCI was retrospectively enrolled between January 2010 and April 2016 in the Guangdong Provincial People's Hospital.The relationship between NPR and inhospital and 1-year mortality was evaluated.Results A total of 767 elderly patients with STEMI were included and divided into three groups according to the tertiles of NPR:<37(n=253),37-54(n=257),and≥54(n=257).Multivariate logistic regression analysis showed an independent correlation between elevated NPR and in-hospital death[odds ratio(OR)=1.02,95%confidential interval(CI):1.01-1.03,P<0.001].The receiver operating characteristic curve(AUC)analysis demonstrated a relatively high predictive value for NPR in identifying in-hospital death(AUC=0.765,95%CI:0.704-0.825,P<0.001,sensitivity=77.1%,specificity=69.0%,optimal cut-off value=54).As for 1-year mortality,multivariate Cox survival analysis revealed that NPR[hazard ratio(HR)=1.003,95%CI:1.001-1.004,P<0.001],as a continuous variable,and NPR>54(HR=2.70,95%CI 1.72-4.22,P<0.001),as a categorial variable,were both independent predictors for 1-year mortality.Conclusions NPR is a feasible predictor of poor prognosis for elderly patients with STEMI receiving PCI.

Factors associated with relocation stress for the families of patients transferred from intensive care units after cardiac valvular and aortic surgery

Background Relocation stress is common among the families of patients transferred from intensive care units.However,few studies investigated the factors associated with relocation stress for the families of patients after cardiac valvular and aortic surgery.The objective of this study was to investigate the relocation stress status and associated factors in the family members of patients transferred out of the intensive care unit(ICU)after cardiac valvular and aortic surgery.Methods A total of 120 family members of patients,who were successfully transferred out of ICU after cardiac valvular and aortic surgery from October 2020 to February 2021 in our institution,were included.Their demographic characteristics,clinical characteristics and relocation stress assessment results were collected.Risk factors for relocation stress were investigated using linear regression models.Results The overall mean scores of our research subjects on relocation stress was 55.68±4.658.Univariate analysis and multivariable linear regression analysis revealed that family members.age,patients.residence,and duration of ICU stay were risk factors of post-ICU relocation stress in family members of patients after cardiac valvular and aortic surgery(P<0.05).Conclusions The relocation stress in family members of patients transferred from ICU after cardiac valvular and aortic surgery was moderate to high.Younger age of family members,patients living in rural areas,and longer duration of ICU stay are associated with a higher level of relocation stress.Healthcare providers should concern the relocation stress in family members of patients transferred from ICU after cardiac valvular and aortic surgery,and appropriate intervention measures should be carried out.