Heart failure (HF) is known to be one of the major problems in the cardiovascular field needed to be urgently addressed due to its high incidence, high mortality and poor prognosis. Searching for the optimal risk assessment method is currently a priority effort in this field. Recent studies have identified inflammation as one of the important pathophysiological mechanisms in the development and progress of HF, the detection and evaluation of multiple inflammatory indicators may be an important method to predict the regression of HF, therefore, exploration of simple and easy-to-perform inflammatory predictors with the optimal comprehensive performance is becoming a focus of attention.

To explore the predictive value of (neutrophil + monocyte) /lymphocyte ratio (NMLR) in peripheral blood on the in-hospital mortality of HF patients.

A total of 583 patients with HF admitted to Puyang Oilfield General Hospital from January 2020 to September 2022 were collected and divided into the survival group (n=564) and the death group (n=19) according to the occurrence of all-cause death during hospitalization. The baseline data was collected including demographic characteristic, complications, primary disease and laboratory test results; multivariate Cox analysis was used to explore the influencing factors of in-hospital mortality in HF patients; restrictive cubic spline (RCS) was used to determine the relationship between NMLR and in-hospital mortality in HF patients; receiver operating characteristic (ROC) curve was plotted to explore the predictive value of NMLR for in-hospital mortality of HF patients and calculate the optimal cut-off value; Kaplan-Meier method was used to plot the survival curves of patients with different NMLR values.

The NMLR at admission in the death group〔8.36 (3.15, 9.55) 〕 was higher than that in the survival group〔5.00 (3.23, 8.72) 〕 (P<0.05), The results of multivariate Cox proportional hazards regression model showed that NMLR was the influencing factor of in-hospital mortality in HF patients〔HR=1.003, 95%CI (1.001, 1.005), P<0.05〕; the area under ROC curve for NMLR to predict in-hospital mortality of HF patients was 0.704〔95%CI (0.652, 0.757) 〕, with the optimal cut-off value of 7.93. The RCS showed a non-linear positive correlation between the NMLR value and the risk of in-hospital mortality in patients with HF (P<0.05). The in-hospital survival was lower in patients with NMLR≥7.93 than those with NMLR<7.93 (χ²=111.843, P<0.001) .

The elevated NMLR value at admission maybe an independent predictor of in-hospital mortality in HF patients.

心力衰竭（HF）由于其高发病率、高死亡率和不良预后，是心血管领域急需解决的主要难题之一。探寻最佳的风险评估方法是目前本领域的研究方向。近年来研究发现炎症是HF发生和发展的重要病理生理机制之一，多种炎性指标的检测和评估可能是预测HF转归的重要方法，探究简便易行、综合性能最佳的炎性预测指标逐渐成为人们关注的重点。

探讨外周血（中性粒细胞+单核细胞）/淋巴细胞比值（NMLR）对HF患者住院死亡的预测价值。

纳入2020年1月—2022年9月濮阳市油田总医院住院的HF患者583例。根据患者是否出现住院死亡分为生存组（n=564）与死亡组（n=19），收集患者基线资料包括人口学特征、合并症、HF原发疾病、实验室检查结果；采用多因素Cox比例风险回归分析探究HF患者住院死亡的影响因素，采用限制性立方样条（RCS）确定NMLR与HF患者住院死亡的关系；绘制受试者工作特征（ROC）曲线探究NMLR对HF患者住院死亡的预测价值并计算最佳截断值；采用Kaplan-Meier法绘制不同NMLR水平患者的生存曲线。

死亡组入院时NMLR〔8.36（3.15，9.55）〕高于生存组〔5.00（3.23，8.72）〕（P<0.05）。多因素Cox比例风险回归分析结果显示，NMLR是HF患者住院死亡的影响因素〔HR=1.003，95%CI（1.001，1.005），P<0.05〕。NMLR预测HF患者住院死亡的ROC曲线下面积为0.704〔95%CI（0.652，0.757）〕，最佳截断值为7.93。RCS显示NMLR与HF患者住院死亡风险呈非线性正相关（P<0.05）。NMLR≥7.93者的住院生存率低于NMLR<7.93者（χ²=111.843，P<0.001）。

入院时NMLR升高可能是HF患者住院死亡的独立预测因素。