Predictive Value of the Neutrophil-to-Lymphocyte Ratio, MPV-to-Platelet Ratio, and Other Risk Factors for Mortality in Candidemia Patients: A 10-year retrospective analysis

Background Candidaemia is a leading cause of mortality in hospitalized patients. The determination of risk factors is necessary to predict mortality. We aimed to evaluate whether the neutrophil, lymphocyte, monocyte, and platelet counts; red blood cell distribution width (RDW), mean platelet volume (MPV), neutrophil/lymphocyte (N/L) and MPV/platelet count (MPV/plt) ratios and other clinical features are risk factors for mortality. Methods This study was retrospective and observational. Patients aged 18 years and older who were hospitalized in the intensive care unit between January 1, 2014, and January 1, 2024, who had Candida detected via blood culture, were included in the study. Logistic regression analysis was used to identify independent risk factors. Results The mean age of the 468 patients was 64.26 ± 15.9 years, and 204 (43.6%) were female. A total of 321 patients (68.6%) died. The most common comorbid disease was malignancy (n = 171, 36.5%), whereas 482 candidemia episodes were detected. Candida parapsilosis (n = 239, 49.6%) was the most frequently observed strain. Higher age, congestive heart failure (CHF), higher neutrophil count, RDW > 17.1/%, low albumin level, low platelet count, lymphocyte count < 1000/mm3, total parenteral nutrition (TPN) support, mechanical ventilation (MV) support, immunosuppressive drug use and Candida glabrata were independent risk factors for mortality. Conclusions We concluded that the N/L ratio and the MPV/plt ratio are not risk factors, but the neutrophil, lymphocyte and platelet counts; RDW, albumin level, age, MV, TPN, CHF, immunosuppressive drug use; and C. glabrata count were independent risk factors for mortality. We believe that clinicians can decrease mortality rates in their units by examining these risk factors and taking necessary precautions.