Exploring the value of routinely measured hematology parameters for identification of elderly patients at high risk of death at the Emergency Department

Abstract

Of the warning scores in use for recognition of high-risk patients at the Emergency Department (ED), few incorporate laboratory results. Although hematological characteristics have shown prognostic value in small studies, large studies in elderly ED populations are lacking. We studied the association between blood cell and platelet counts and characteristics as well as C-reactive protein (CRP) at ED presentation with mortality in non-multitrauma patients ≥ 65 years. Comparison between survivors and non-survivors showed small, significant differences with AUROCs ranging between 56.6% and 65.2% for 30-day mortality. Combining parameters yielded an evident improvement (AUROC of 70.4%). Efforts should be pursued to study the added value of hematological parameters on top of clinical data when assessing patient risk.

Added diagnostic value of routinely measured hematology variables in diagnosing immune checkpoint inhibitor mediated toxicity in the emergency department

“…This study raises the question if the hematological variables might also have diagnostic value in the setting of other diseases and treatments 11–13 . As they are inexpensive and relatively easily and rapidly obtained in general blood counts, they could be an interesting new tool in future diagnostic research.…”

“…This study raises the question if the hematological variables might also have diagnostic value in the setting of other diseases and treatments. 11 , 12 , 13 As they are inexpensive and relatively easily and rapidly obtained in general blood counts, they could be an interesting new tool in future diagnostic research. As shown here, a clinical diagnostic model may aid the clinical decision‐making process of a physician by providing a continuous prediction score that can be combined with the professional interpretation by a clinical chemist to accommodate integral diagnostics of a patient's clinical state.…”

“…This raises the question whether they may also be of use in the setting of immunological toxicity. [11][12][13] To answer these types of questions, scrutinizing complex datasets with conventional statistical methods, such as logistic regression, do not provide stable estimates of the variable's coefficients as models contain too many variables and a low number of samples. New advanced statistical and machine learning (ML) methods are able to remove irrelevant variables thereby reducing the number of variables.…”

“…Most modern hematology analyzers not only provide blood cell counts, but also measure morphologic characteristics, such as cell size, intrinsic properties and cell viability that carry diagnostic and prognostic value. This raises the question whether they may also be of use in the setting of immunological toxicity 11–13 …”

“…This raises the question whether they may also be of use in the setting of immunological toxicity. 11 , 12 , 13 …”