{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T23:17:38Z","timestamp":1764890258040,"version":"3.46.0"},"reference-count":36,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the National Natural Science Foundation of China -China State Railway Group Co., Ltd. Railway Fundamental Research Joint Fund","award":["U2368213"],"award-info":[{"award-number":["U2368213"]}]},{"name":"Innovation and Technology Commercialization Fund of Xiangya Hospital, Central South University","award":["2024ZHJJ06"],"award-info":[{"award-number":["2024ZHJJ06"]}]},{"name":"the National Key Research and Development Program of China","award":["2022YFC2009801","2022YFC2009805"],"award-info":[{"award-number":["2022YFC2009801","2022YFC2009805"]}]},{"name":"Scientific and Technological Personnel Lifting Project in Hunan Province","award":["2023TJ-Z11"],"award-info":[{"award-number":["2023TJ-Z11"]}]},{"name":"Changsha Science and Technology Plan Project","award":["kq2202059"],"award-info":[{"award-number":["kq2202059"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,9,28]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      This study aims to explore the associations of the neutrophil-to-lymphocyte ratio (NLR) and the systemic inflammatory response index (SIRI) with all-cause mortality among adults with nasal colonisation of\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (\n                      <jats:italic>S. aureus<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The National Health and Nutrition Examination Survey (2001\u20132004).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      A total of 10\u2009600 adults aged 18 years or older were included in this study, of whom 2805 were colonised with nasal\n                      <jats:italic>S. aureus<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>All-cause mortality was considered as primary outcomes. Survey-weighted Cox proportional hazards models were applied to evaluate the associations of NLR and SIRI with all-cause mortality after adjustment for confounders. Predictive performance was assessed using time-dependent receiver operating characteristic (ROC) curves, and survival differences were illustrated by Kaplan-Meier (K-M) analysis. Restricted cubic spline (RCS) models further examined potential non-linear associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median follow-up of 197 months, 595 deaths occurred. The fully adjusted Cox model showed that elevated NLR (1.87 (1.32, 2.65), p&lt;0.001) and SIRI (1.88 (1.43, 2.48), p&lt;0.001) were significantly associated with increased all-cause mortality risk. These associations were consistent across subgroup analyses by sex, age, education, race, family poverty income ratio, smoking, drinking, diabetes, cancer and long-term care. K-M curves showed significantly lower survival rates in high NLR and SIRI groups (p&lt;0.0001). RCS analysis revealed non-linear relationships between NLR and SIRI, with all-cause mortality (p&gt;0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Elevated NLR and SIRI levels are positively associated with higher all-cause mortality risk among adult individuals with nasal\n                      <jats:italic>S. aureus<\/jats:italic>\n                      colonisation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-104399","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T07:00:53Z","timestamp":1761116453000},"page":"e104399","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of NLR and SIRI with all-cause mortality among adults with nasal\n                    <i>Staphylococcus aureus<\/i>\n                    colonisation: a cross-sectional study of NHANES, 2001\u20132004"],"prefix":"10.1136","volume":"15","author":[{"given":"Ju","family":"Zou","sequence":"first","affiliation":[{"name":"Department of Infection Control Center, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"Super drug-resistant Organism Infection Prevention and Control Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanyuan","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Infection Control Center, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"Super drug-resistant Organism Infection Prevention and Control Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biyue","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Infection Control Center, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"Super drug-resistant Organism Infection Prevention and Control Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Infection Control Center, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"Super drug-resistant Organism Infection Prevention and Control Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anhua","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Infection Control Center, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"Super drug-resistant Organism Infection Prevention and Control Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, 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