In critically ill patients, inflammation causes vascular endothelial dysfunction in microcirculation as well as platelet activation and consumption. The NLR is a potent indicator of inflammation 5, while the MPV is an indicator of platelet activation. However, there is an emerging need for a simple and readily available inflammatory marker such as the neutrophil to lymphocyte ratio (NLR) or mean platelet volume (MPV) to function as a prognostic indicator for patients in the intensive care unit (ICU). For this reason, there has been extensive investigation into the prognostic abilities of various inflammatory biomarkers, including C-reactive protein (CRP) and procalcitonin, in critically ill patients 3, 4. Most critically ill patients have cardiovascular instability and systemic inflammatory responses. Although several predictive tools have been suggested to predict mortality in critically ill patients, including the Acute Physiological and Chronic Health Evaluation (APACHE) II and the Sequential Organ Failure Assessment (SOFA), there are few predictive factors that are accurate, easy to use, and readily available in critically ill patients with various diseases 1, 2. The ability to predict a poor prognosis in critically ill patients is vitally important in determining a treatment strategy. Our data showed that the MPV/platelet ratio is a predictive factor for 1-year mortality in critically ill patients. The MPV/platelet ratio was an independent predictor for 1-year mortality based on the Kaplan–Meier survival analysis. The incidence of 1-year mortality was the highest in the third tertile for both the NLR and MPV/platelet ratio. The NLR and MPV/platelet ratio were higher in the non-survivor group than in the survivor group. Kaplan–Meier survival curves were plotted to evaluate their potential as prognostic factors for 1-year mortality. Patients were classified into tertiles based on their NLR and MPV/platelet ratios, and the incidence of 1-year mortality was compared. We compared the NLR and MPV/platelet ratio on each day of ICU admission. Patients were divided into 2 groups according to 1-year mortality. We retrospectively reviewed 1,154 patients admitted to the intensive care unit (ICU) between January 2017 and December 2017. This study investigated whether NLR and/or the MPV/platelet ratio could function as predictive markers of mortality in critically ill patients. Several studies have reported that the neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) are associated with poor prognosis.
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