Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Medicine, National Yang-Ming University, Taipei, Taiwan.
Sci Rep. 2017 Dec 19;7(1):17828. doi: 10.1038/s41598-017-17754-8.
Hemographic indices have been associated with clinical outcomes in patients with chronic heart failure. We therefore investigated the prognostic values of hemographic indices in patients hospitalized for acute heart failure (AHF). Patients hospitalized primarily for AHF were drawn from an intramural registry. Hemographic indices, including white blood cell counts, neutrophil counts, neutrophil-to-lymphocyte ratio, reciprocal of lymphocyte (RL) and platelet-to-lymphocyte ratio were recorded. Among a total of 1923 participants (mean age 76 ± 12 years, 68% men), 875 patients died during a mean follow-up of 28.6 ± 20.7 months. Except for white blood cell counts, all the other hemographic indices were related to mortality, independently. In a forward stepwise Cox regression analysis among hemographic indices, RL was the strongest predictor (HR and 95% CI per-1SD:1.166,1.097-1.240) for mortality, after accounting for confounders. However, conditioned on the survivals, the hemographic indices were independently related to mortality within 3 years of follow-up, rather than beyond. Hemographic indices were independent risk factors of mortality in patients hospitalized for AHF, especially in patients with impaired left ventricular systolic function. As an acute presentation of inflammation, hemographic indices might be useful to identify subjects at risk of mortality soon after the index hospitalization.
血液学指标与慢性心力衰竭患者的临床结局相关。因此，我们研究了血液学指标在因急性心力衰竭（AHF）住院的患者中的预后价值。因 AHF 住院的患者来自院内注册登记。记录了血液学指标，包括白细胞计数、中性粒细胞计数、中性粒细胞与淋巴细胞比值、淋巴细胞倒数（RL）和血小板与淋巴细胞比值。在总共 1923 名参与者（平均年龄 76±12 岁，68%为男性）中，875 名患者在平均 28.6±20.7 个月的随访期间死亡。除了白细胞计数外，所有其他血液学指标均与死亡率独立相关。在对血液学指标进行逐步向前 Cox 回归分析中，RL 是死亡率最强的预测指标（每 1SD 的 HR 和 95%CI：1.166，1.097-1.240），在考虑了混杂因素后。然而，在生存条件下，血液学指标与随访 3 年内的死亡率独立相关，而不是随访 3 年以后。血液学指标是因 AHF 住院患者死亡率的独立危险因素，尤其是在左心室收缩功能受损的患者中。作为炎症的急性表现，血液学指标可能有助于在指数住院后不久识别有死亡风险的患者。
