Rahimi-Levene Naomi, Preisler Yoav, Koren-Michowitz Maya, Peer Victoria, Zeidenstein Ronit, Golik Ahuva, Ziv-Baran Tomer
Blood Bank, Shamir Medical Center, Zerifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Hematology Institute, Shamir Medical Center, Zerifin, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Am J Med Sci. 2021 Sep;362(3):276-284. doi: 10.1016/j.amjms.2021.04.017. Epub 2021 May 9.
Patients hospitalized with acute heart disease [acute myocardial infarction (MI); heart disease exacerbation] may require red blood cell (RBC) transfusion. These patients are at increased risk for morbidity and mortality. Hematological biomarkers may help to identify increased mortality risk. The aim of the study was to evaluate the association between hematological biomarkers and survival in these patients.
A historical cohort study of all patients admitted to an internal medicine department, who were diagnosed with acute heart disease and requiring RBC transfusion, was carried out in a tertiary medical center between 2009-2014. The association between hematological biomarkers and 30-, 90-day and 5-year mortality was studied.
A total of 254 patients (median age 80 years, IQR 74-86.25; 40.9% females; acute MI 24.8%), were included. During the 5-year follow-up 212(83.5%) patients died. In a multivariate analysis the lower platelet to neutrophil ratio (PNR) was significantly associated with increased 30-, 90-day and 5-year mortality (p<0.001, 0.041, 0.003 respectively). A higher red cell distribution width (RDW) was significantly associated with 30- and 90-day mortality (p=0.003, 0.023 respectively), while higher neutrophil to lymphocyte ratio (NLR) was associated with increased 30-day and 5-year mortality (p= 0.036, 0.033 respectively).
Hematological biomarkers may help to identify increased mortality risk of acute heart disease patients, receiving RBC transfusions in an internal medicine department.
因急性心脏病（急性心肌梗死；心脏病加重）住院的患者可能需要输注红细胞（RBC）。这些患者的发病和死亡风险增加。血液生物标志物可能有助于识别死亡风险增加的情况。本研究的目的是评估血液生物标志物与这些患者生存率之间的关联。
在一家三级医疗中心对2009年至2014年间内科收治的所有被诊断为急性心脏病且需要输注RBC的患者进行了一项历史性队列研究。研究了血液生物标志物与30天、90天和5年死亡率之间的关联。
共纳入254例患者（中位年龄80岁，四分位间距74 - 86.25；女性占40.9%；急性心肌梗死占24.8%）。在5年随访期间，212例（83.5%）患者死亡。多因素分析显示，较低的血小板与中性粒细胞比值（PNR）与30天、90天和5年死亡率增加显著相关（分别为p<0.001、0.041、0.003）。较高的红细胞分布宽度（RDW）与30天和90天死亡率显著相关（分别为p = 0.003、0.023），而较高的中性粒细胞与淋巴细胞比值（NLR）与30天和5年死亡率增加相关（分别为p = 0.036、0.033）。
血液生物标志物可能有助于识别在内科接受RBC输血的急性心脏病患者死亡风险增加的情况。
