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Background <p>Mortality risk stratification in older emergency department (ED) patients remains challenging in resource-limited settings, particularly among frail elderly with multiple comorbidities. This study evaluated the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in Southern Iran.</p> Methods <p>In this retrospective single-center study conducted between March 2021 and March 2022, we analyzed records of 2,540 consecutively admitted patients aged ≥ 65 years to an academic ED in Southern Iran. NLR was calculated from initial complete blood counts.</p> Results <p>An NLR &gt; 3.75 predicted in-hospital mortality with 52.2% sensitivity and 75.8% specificity (AUC = 0.655; 95% CI: 0.636–0.674; <i>p</i> &lt; 0.001). Multivariate analysis confirmed NLR as an independent predictor (adjusted OR = 1.77; 95% CI: 1.28–2.44). An inverse association was observed between hypernatremia and mortality risk (OR = 0.68; 95% CI: 0.57–0.82).</p> Conclusions <p>NLR &gt; 3.75 may serve as a supportive and low-cost indicator for mortality risk stratification in elderly emergency patients; however, it should not be considered a stand-alone triage tool. The unexpected inverse association with hypernatremia warrants cautious interpretation and validation in future studies.</p>

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Neutrophil-to-lymphocyte ratio as a predictor of in-hospital mortality in elderly emergency patients: a retrospective study from Southern Iran

  • 期刊论文

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  • 发表日期：

    2026年2月12日

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  • Latife Jabbari,
  • Maryam Yousefzade,
  • Saeed Hosseini Teshnizi,
  • Leila Azizkhani,
  • Saeed Hayati

摘要

Background

Mortality risk stratification in older emergency department (ED) patients remains challenging in resource-limited settings, particularly among frail elderly with multiple comorbidities. This study evaluated the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in Southern Iran.

Methods

In this retrospective single-center study conducted between March 2021 and March 2022, we analyzed records of 2,540 consecutively admitted patients aged ≥ 65 years to an academic ED in Southern Iran. NLR was calculated from initial complete blood counts.

Results

An NLR > 3.75 predicted in-hospital mortality with 52.2% sensitivity and 75.8% specificity (AUC = 0.655; 95% CI: 0.636–0.674; p < 0.001). Multivariate analysis confirmed NLR as an independent predictor (adjusted OR = 1.77; 95% CI: 1.28–2.44). An inverse association was observed between hypernatremia and mortality risk (OR = 0.68; 95% CI: 0.57–0.82).

Conclusions

NLR > 3.75 may serve as a supportive and low-cost indicator for mortality risk stratification in elderly emergency patients; however, it should not be considered a stand-alone triage tool. The unexpected inverse association with hypernatremia warrants cautious interpretation and validation in future studies.