ĐA NHÂN TRUNG TÍNH/BẠCH CẦU LYMPHO Ở BỆNH NHÂN HỘI CHỨNG VÀNH CẤP TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Objective: This study aimed to determine the 90-day readmission and mortality rates, as well as to evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) for these outcomes in patients with acute coronary syndrome at Cho Ray Hospital. Subjects and Methods: A combined retrospective and prospective cohort study was conducted on 307 patients with acute coronary syndrome admitted to the Interventional Cardiology Department of Cho Ray Hospital from August 2024 to March 2025. Clinical and laboratory data, including the neutrophil-to-lymphocyte ratio (NLR) at admission, were collected. Data were analyzed using SPSS software, with ROC curve analysis and logistic regression applied to determine the prognostic value of NLR. Results: The 90-day adverse event rate was 14%, including 2.9% mortality and 11.1% hospital readmission. The mean neutrophil-to-lymphocyte ratio (NLR) was 4.8 ± 2.7; patients who experienced adverse events had significantly higher NLR values compared to those without events (p < 0.05). Receiver operating characteristic (ROC) analysis identified an optimal NLR cutoff of 2.855, with a sensitivity of 88.4%, specificity of 29.9%, and an area under the curve (AUC) of 0.538 (95% CI: 0.452–0.624; p = 0.426). Multivariate logistic regression showed that NLR ≥ 2.855 increased the risk of death or readmission by 3.07 times (95% CI: 1.14–8.25; p = 0.025), independent of age or comorbidities. In addition, Killip class > I and left ventricular ejection fraction (EF) ≤ 40% were also identified as predictors of poor outcomes. These findings confirm that elevated NLR reflects an enhanced inflammatory response and is associated with worse prognosis in patients with acute coronary syndrome (ACS). Conclusion: Admission NLR is an independent prognostic factor associated with 90-day mortality and readmission in ACS patients, allowing early identification of high-risk individuals who may experience adverse short-term outcomes.