Comparative role of hematological indices for the assessment of in-hospital outcome of heart failure patients. (30th July 2021)

• Record Type: Journal Article
• Authors: Delcea, Caterina; Buzea, Catalin Adrian; Vijan, Ancuta; Draghici, Anamaria; Stoichitoiu, Laura Elena; Dan, Gheorghe-Andrei
• Is Part Of: Scandinavian cardiovascular journal. Volume 55:Number 4(2021)
• Page Start: 227
• Page End: 236
• Publication Date: 2021-07-30
• Subjects: Heart failure -- HI-HF cohort -- lymphocyte-monocyte ratio -- neutrophil-lymphocyte ratio -- platelet-lymphocyte ratio; Cardiovascular system -- Diseases -- Periodicals; 617.41
• DOI: 10.1080/14017431.2021.1900595
• Languages: English
• ISSNs: 1401-7431

Abstract

Abstract: Background . The mutual relation between heart failure (HF) and inflammation is reflected in blood cell homeostasis. Neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR) and platelet-lymphocyte ratio (PLR) were linked to HF severity and prognosis. Aims . Our objective was to compare the three ratios for predicting in-hospital outcome of HF patients, in order to establish which is best suited for clinical practice. Methods . Consecutive HF patients admitted to a Cardiology Department from a tertiary hospital were retrospectively evaluated for inclusion. Readmissions and pathologies modifying the hematological indices were excluded. Extended length of hospital stay (LOS) was considered over 7 d. In-hospital all-cause mortality was evaluated. Results: The hematological indices in heart failure (HI-HF) cohort included 1299 patients with a mean age of 72.35 ± 10.45 years, 51.96% women. 2.85% died during hospitalization. 22.17% had extended LOS. In Cox regression for in-hospital mortality alongside parameters from the OPTIMIZE-HF proposed model, all three ratios were independent predictors of mortality. In Cox regression including NT-proBNP, dyspnea at rest, chronic obstructive pulmonary disease (COPD), age and systolic blood pressure, only MLR was an independent predictor of in-hospital mortality (HR 1.68, 95% CI 1.22 − 2.32, p = .002). In multivariable logistic regression, all three ratios independently predicted extended LOS. MLR > 0.48 associated the highest probability (OR 1.76, 95% CI 1.25 − 2.46, p = .001). Conclusions. Hematological indices could be cost-effective and easily available auxiliary biomarkers for in-hospital prognosis of HF patients. We propose MLR > 0.48 as the strongest predictor of in-hospital mortality and prolonged hospitalization.