Evidence map›Paper›PMID 41366182›Full record

ArticleClinical rheumatology2026

Non-linear association of admission platelet-to-lymphocyte ratio with 28- and 90-day mortality in critically ill patients with rheumatoid arthritis: a retrospective cohort study.

Jing Yuan, Wan-Zhu Liu, Dian-Chen Wu, Feng-Yun Jia, Jia-Ying Yang, Xi Cao, Zhou Zhou, Jun Tan

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Article in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Jing YuanDepartment of Rheumatology and Immunology, Affiliated People's Hospital of Jiangsu University, Dianli Road 8, Zhenjiang, 212000, Jiangsu, People's Republic of China.
Wan-Zhu LiuDepartment of Emergency, Affiliated People's Hospital of Jiangsu University, Jiangsu, Zhenjiang, China.
Dian-Chen WuDepartment of Rheumatology and Immunology, Affiliated People's Hospital of Jiangsu University, Dianli Road 8, Zhenjiang, 212000, Jiangsu, People's Republic of China.
Feng-Yun JiaDepartment of Rheumatology and Immunology, Affiliated People's Hospital of Jiangsu University, Dianli Road 8, Zhenjiang, 212000, Jiangsu, People's Republic of China.
Jia-Ying YangDepartment of Rheumatology and Immunology, Affiliated People's Hospital of Jiangsu University, Dianli Road 8, Zhenjiang, 212000, Jiangsu, People's Republic of China.
Xi CaoDepartment of Rheumatology and Immunology, Affiliated People's Hospital of Jiangsu University, Dianli Road 8, Zhenjiang, 212000, Jiangsu, People's Republic of China.
Zhou ZhouDepartment of Neurosurgery, Affiliated People's Hospital of Jiangsu University, Dianli Road 8, Zhenjiang, 212000, Jiangsu, People's Republic of China. yzzj1411@163.com.ORCID http://orcid.org/0000-0003-2889-8580
Jun TanDepartment of Rheumatology and Immunology, Affiliated People's Hospital of Jiangsu University, Dianli Road 8, Zhenjiang, 212000, Jiangsu, People's Republic of China. zjyytj@126.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCritically ill patients with rheumatoid arthritis (RA) have high short-term mortality. The platelet-to-lymphocyte ratio (PLR) reflects RA inflammatory activity. We evaluated whether admission PLR is associated with 28- and 90-day mortality in critically ill patients with RA.

methodsRA patients were identified from the MIMIC-IV database. Restricted cubic spline (RCS) Cox models characterized the PLR-mortality association and defined a log PLR threshold. Patients were stratified into low, middle, and high PLR groups using this threshold with a ± 0.3 margin (δ). Cumulative incidence of death was assessed using the Kaplan-Meier method. Piecewise Cox models were constructed with incremental adjustment. Subgroup analyses tested the consistency of PLR's effect across different strata.

resultsAmong 989 patients, 28- and 90-day mortality were 16.4% and 23.5%. RCS analysis showed a U-shaped association, with the lowest risk at log PLR = 4.725 and higher hazards toward both extremes. In piecewise Cox models, each + 1 log PLR was associated with lower mortality in the low PLR segment (28-day hazard ratio (HR) 0.59; 90-day HR 0.61) but higher risk in the high PLR segment (28-day HR 1.72; 90-day HR 1.67). Associations persisted after multivariable adjustment, with consistent subgroup trends.

conclusionsAdmission PLR is a significant prognostic marker in critically ill RA, demonstrating a U-shaped relationship with 28- and 90-day mortality. Both abnormally low and high PLR values were associated with higher mortality. Key Points • Admission PLR shows a U-shaped, independent association with 28- and 90-day mortality, with the lowest risk at log PLR 4.725 (~ PLR ≈112). • Threshold groups (PLR < ~ 84, 84 -153) and piecewise Cox models reveal decreasing risk below and increasing risk above the cutoff, persisting after multivariable adjustment. • Effects remain after multivariable adjustment and are consistent across clinical subgroups. • As a routine CBC metric, PLR enables simple early ICU risk stratification for RA, highlighting excess risk at both extremes.

Indexed as

Arthritis, RheumatoidBlood PlateletsLymphocytesAdultAgedCritical IllnessFemaleHumansKaplan-Meier EstimateLymphocyte CountMaleMiddle AgedPlatelet CountPrognosisProportional Hazards ModelsRetrospective StudiesCritical illnessInflammationIntensive careMortalityPlatelet-to-lymphocyte ratioRheumatoid arthritis

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.