Liu Lei, Dong Xuetao, Liu Yaodong, Wang Shaozhen, Wei Liudong, Duan Lian, Zhang Qingjun, Zhang Kun
Department of Neurosurgery, Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing, China.
Front Neurol. 2024 Jan 12;14:1222717. doi: 10.3389/fneur.2023.1222717. eCollection 2023.
To explore the predictive value of white blood cell to hemoglobin ratio (WHR) for 30-day mortality in patients with intracerebral hemorrhage (ICH).
In this cohort study, 2,848 patients with ICH were identified in the Medical Information Mart for Intensive Care (MIMIC)-III and MIMIC-IV. Least absolute shrinkage and selection operator (LASSO) regression screened covariates of 30-day mortality of ICH patients. COX regression analysis was used to study the association of different levels of WHR, white blood cell (WBC), and hemoglobin (Hb) with 30-day mortality. The median follow-up time was 30 (20.28, 30.00) days.
In total, 2,068 participants survived at the end of the follow-up. WHR was negatively correlated with the Glasgow Coma Score (GCS) (spearman correlation coefficient = -0.143, < 0.001), and positively associated with the Sepsis-related Organ Failure Assessment (SOFA) score (spearman correlation coefficient = 0.156, < 0.001), quick SOFA (qSOFA) score (spearman correlation coefficient = 0.156, < 0.001), and Simplified Acute Physiology Score II (SAPS-II) (spearman correlation coefficient = 0.213, < 0.001). After adjusting for confounders, WHR >0.833 (HR = 1.64, 95%CI: 1.39-1.92) and WBC >10.9 K/uL (HR = 1.49, 95%CI: 1.28-1.73) were associated with increased risk of 30-day mortality of patients with ICH. The area under the curve (AUC) value of the prediction model based on WHR and other predictors was 0.78 (95%CI: 0.77-0.79), which was higher than SAPSII (AUC = 0.75, 95%CI: 0.74-0.76), SOFA score (AUC = 0.69, 95%CI: 0.68-0.70) and GCS (AUC = 0.59, 95%CI: 0.57-0.60).
The level of WHR was associated with 30-day mortality in patients with severe ICH, and the WHR-based prediction model might provide a tool to quickly predict 30-day mortality in patients with ICH.
探讨白细胞与血红蛋白比值（WHR）对脑出血（ICH）患者30天死亡率的预测价值。
在本队列研究中，从重症监护医学信息数据库（MIMIC）-III和MIMIC-IV中识别出2848例ICH患者。采用最小绝对收缩和选择算子（LASSO）回归筛选ICH患者30天死亡率的协变量。使用COX回归分析研究不同水平的WHR、白细胞（WBC）和血红蛋白（Hb）与30天死亡率的关联。中位随访时间为30（20.28，30.00）天。
共有2068名参与者在随访结束时存活。WHR与格拉斯哥昏迷评分（GCS）呈负相关（斯皮尔曼相关系数=-0.143，<0.001），与脓毒症相关器官功能衰竭评估（SOFA）评分（斯皮尔曼相关系数=0.156，<0.001）、快速SOFA（qSOFA）评分（斯皮尔曼相关系数=0.156，<0.001）和简化急性生理学评分II（SAPS-II）呈正相关（斯皮尔曼相关系数=0.213，<0.001）。在调整混杂因素后，WHR>0.833（HR=1.64，95%CI：1.39-1.92）和WBC>10.9 K/μL（HR=1.49，95%CI：1.28-1.73）与ICH患者30天死亡风险增加相关。基于WHR和其他预测因素的预测模型的曲线下面积（AUC）值为0.78（95%CI：0.77-0.79），高于SAPSII（AUC=0.75，95%CI：0.74-0.76）、SOFA评分（AUC=0.69，95%CI：0.68-0.70）和GCS（AUC=0.59，95%CI：0.57-0.60）。
WHR水平与重症ICH患者的30天死亡率相关，基于WHR的预测模型可能为快速预测ICH患者的30天死亡率提供一种工具。
