The neutrophil-to-lymphocyte ratio as a predictor of all-cause mortality in individuals with anemia: A population-based study

Xiangkuan Cheng, Lanling Liu, Yueming Tian, Hong Zhang, Mingdeng Wang and Yuansheng Lin

PLOS ONE, 2026, vol. 21, issue 1, 1-15

Abstract: Background: This study investigates the association between the neutrophil-to-lymphocyte ratio (NLR) and all-cause mortality in individuals with anemia using the National Health and Nutrition Examination Survey (NHANES) 1999–2018 dataset. Methods: We included 3,212 participants with anemia, categorized into three groups by NLR values. Baseline characteristics, comorbidities, and demographics were analyzed. We performed univariate logistic regression, multivariable Cox regression, non-linear regression, and breakpoint analysis to examine NLR-mortality relationships. Subgroup analysis assessed effect modification by clinical factors. Results: The mean age of the cohort was 56.0 ± 18.3 years. Participants in the highest NLR tertile (T3) had significantly higher mortality risk, with an HR of 1.25 (95% CI:1.07–1.48, p = 0.007) in the fully adjusted model. Univariate logistic regression showed that NLR was independently associated with mortality (odds ratio [OR] = 1.44, 95% confidence interval [CI]: 1.35–1.52, p

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0338129

DOI: 10.1371/journal.pone.0338129

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