This study aimed to examine the association between the neutrophil-to-lymphocyte ratio (NLR) and the prognosis of patients with breast cancer (BC) in southern Ethiopia.

We conducted a hospital-based retrospective cohort study.

The study was conducted at Hawassa and Wolaita Sodo University Comprehensive Specialized Hospital.

A total of 492 women with BC diagnosed from January 2020 to December 2022 were enrolled. Follow-up extended from the date of diagnosis until the occurrence of an event (death), loss to follow-up or the study end date.

Data were collected using a structured data collection tool through medical record review and exported to Stata V.16 for analysis. Unweighted and weighted Kaplan-Meier survival curves were used to estimate death-free survival time. Inverse-probability-weighted regression adjustment was employed to estimate the association of NLR with time to death. At a statistical significance level of p

The incidence of mortality in patients with BC with a higher NLR was 4.2 (95% CI 3.3 to 5.2) per 100 person-month observation (PMO); it was 1.9 (95% CI 1.5 to 2.4) per 100 PMO for those with a low NLR. When everyone in the population of interest has a low NLR, the average time to death is estimated as 17.2 (95% CI 11.4 to 23.0) months. For women with a higher NLR, the average time to death is estimated as 10.8 (95% CI 8.93 to 12.8) months. For women with a higher NLR, the average time to death was shorter by 6.3 months (coefficient: –6.3, 95% CI –12.5 to –0.082). Furthermore, the effectiveness of exposure to high NLR (ratio of average treatment effect to low NLR potential outcome means) was a 36.7% (95% CI 12% to 61%) reduction in mortality rate.

A high NLR was associated with significantly higher mortality in BC patients, independent of baseline clinicopathological variables. Patients with elevated NLR more often presented with advanced stage disease and distant metastases. These findings indicate that NLR, a simple and accessible biomarker, may help to identify patients at increased risk of poor prognosis.

Central venous catheters (CVCs) are commonly used in intensive care but should be removed as soon as they are no longer needed to reduce infection risk. Peripheral venous access then becomes necessary, but can be challenging due to oedema. Near-infrared light devices, simple non-invasive tools, may assist nurses in this procedure. We hypothesise that a near-infrared light device (AccuVein AV500) could improve the first-attempt success rate of peripheral venous catheter (PVC) placement in intensive care patients no longer requiring a central catheter.

This investigator-initiated, prospective, multicentre, randomised controlled superiority trial compares the near-infrared light device to the landmark approach for PVC insertion in critically ill patients with an existing CVC. A total of three hundred and eighty patients are to be randomised in two parallel groups with a stratification on centre and anticipated difficulty of peripheral venous access.

The study objective is to compare the first-attempt success rate of PVC placement in adult critical care patients for whom a central catheter is no longer indicated.

The protocol and amendments have been approved by the French ethics committee (Comité de Protection des Personnes Sud Ouest et Outre Mer II, Toulouse, France, number 2023-A00429-36), and patients are included after informed consent. The results will be submitted for publication in peer-reviewed journals.

Clinicaltrials.gov: NCT06234293.