Vroonhof Karen, van Solinge Wouter W, Rovers Maroeska M, Huisman Albert
Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Lab Hematol. 2006;12(3):134-8. doi: 10.1532/LH96.06014.
The objective of this descriptive study was to relate hematological parameters of patients visiting the emergency department (ED) to mortality. The study included 1698 adult patients visiting the ED for any reason who underwent blood gas analysis. The results of hemoglobin concentration, leukocyte count, and platelet count were related to mortality within 7 days after admittance to the hospital. When comparing survivors and nonsurvivors, age (mean, 54 versus 63 years, p < .0001) and leukocyte count (median, 10.8 versus 13.9 x 10 (9)/L, p < .0001) showed significant differences. Further analysis was performed by dividing the group of patients according to the reference range. This showed higher mortality in the groups of patients with leukocyte counts outside the reference range (4.0-10.0 x 10 (9)/L, p < .01) and in the group of patients with platelet counts below the reference range (150-450 x 10 (9)/L, p < .0001). High mortality is also seen in the group of women with hemoglobin concentrations outside the reference range (12.1-15.7 g/dL, p < .01), for men no difference was observed. In conclusion, our study shows clinically relevant differences in mortality in hematological parameters in an unselected population at the ED, irrespective of underlying pathology.
这项描述性研究的目的是将急诊科(ED)就诊患者的血液学参数与死亡率相关联。该研究纳入了1698名因任何原因前往急诊科并接受血气分析的成年患者。血红蛋白浓度、白细胞计数和血小板计数的结果与入院后7天内的死亡率相关。在比较幸存者和非幸存者时,年龄(平均,54岁对63岁,p <.0001)和白细胞计数(中位数,10.8对13.9×10⁹/L,p <.0001)显示出显著差异。根据参考范围将患者组进行划分后进行了进一步分析。这表明白细胞计数超出参考范围(4.0 - 10.0×10⁹/L,p <.01)的患者组以及血小板计数低于参考范围(150 - 450×10⁹/L,p <.0001)的患者组死亡率更高。血红蛋白浓度超出参考范围(12.1 - 15.7 g/dL,p <.01)的女性患者组也有较高死亡率,而男性患者未观察到差异。总之,我们的研究表明,在急诊科未经选择的人群中,无论潜在病理情况如何,血液学参数在死亡率方面存在具有临床意义的差异。