Parameters of the complete blood count predict in hospital mortality

Shimoni, Zvi; Froom, Paul; Benbassat, Jochanan

doi:10.1111/ijlh.13684

Cited by 7 publications

(6 citation statements)

References 37 publications

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“…We retrieved the independent (predictor) variables on admission from those available in the hospital electronic database. These variables were the presence of permanent or newly placed urinary catheters on admission, age, gender and laboratory test results that were binned into clinically relevant intervals 17,18 (Tables 2 and 3). We also retrieved data on a history of congestive heart failure, diabetes mellitus, hypertension and chronic obstructive lung disease from the ICD‐9 codes admission diagnoses list that have been shown to predict poor outcomes in surgical patients 19 .…”

Section: Methodsmentioning

confidence: 99%

The presence of a urinary catheter is an important predictor of in‐hospital mortality in internal medicine patients

Shimoni

Froom

Silke

et al. 2022

Evaluation Clinical Practice

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Rationale and Objective: Mortality rates are used to assess the quality of hospital care after appropriate adjustment for case-mix. Urinary catheters are frequent in hospitalized adults and might be a marker of patient frailty and illness severity. However, we know of no attempts to estimate the predictive value of indwelling catheters for specific patient outcomes. The objective of the present study was to (a) identify the variables associated with the presence of a urinary catheter and (b) determine whether it predicts in-hospital mortality after adjustment for these variables. Methods:The study population included all acutely admitted adult patients in 2020 (exploratory cohort) and January-October 2021 (validation cohort) to internal medicine, cardiology and intensive care departments at the Laniado Hospital, a regional hospital with 400 beds in Israel. There were no exclusion criteria. The predictor variables were the presence of a urinary catheter on admission, age, gender, comorbidities and admission laboratory test results. We used bivariate and multivariate logistic regression to test the associations between the presence of a urinary catheter and mortality after adjustment for the remaining independent variables on admission. Results:The presence of a urinary catheter was associated with other independent variables. In 2020, the odds of in-hospital mortality in patients with a urinary catheter before and after adjustment for the remaining predictors were 14.3 (11.6-17.7) and 6.05 (4.78-7.65), respectively. Adding the presence of a urinary catheter to the prediction logistic regression model increased its c-statistic from 0.887 (0.880-0.894) to 0.907 (0.901-0.913). The results of the validation cohort reduplicated those of the exploratory cohort.

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Section: Methodsmentioning

confidence: 99%

The presence of a urinary catheter is an important predictor of in‐hospital mortality in internal medicine patients

Shimoni

Froom

Silke

et al. 2022

Evaluation Clinical Practice

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“…In a previous study, we found that a higher proportion of hypochromic cells was the single best predictor of hospital mortality. 4 The objective of the present study is to determine whether we can reduplicate this finding in another cohort and whether increased proportions of hypochromic cells independently predict not only mortality, but also prolonged hospitalizations, and readmissions within 30 days of discharge in patients with and without anemia.…”

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confidence: 92%

Hypochromic red blood cells is an independent measure of patient frailty

Froom

Shimoni

Benbassat

2023

Int J Lab Hematology

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“…Therefore, it is often restricted to measuring the total white cell count in peripheral blood, a low-cost, easily performed laboratory test. Few studies have reported the predictivity of blood cell count on patient survival under acute and non-acute conditions 1–3. Reference values of blood cell differential counts (BCDCs) are calculated based on the general population, whereas fewer details are known for acutely ill patients.…”

Section: Introductionmentioning

confidence: 99%

Blood cell differential count discretisation modelling to predict survival in adults reporting to the emergency room: a retrospective cohort study

Fumagalli,

Chiarelli,

Cazzaniga

et al. 2023

BMJ Open

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ObjectivesTo assess the survival predictivity of baseline blood cell differential count (BCDC), discretised according to two different methods, in adults visiting an emergency room (ER) for illness or trauma over 1 year.DesignRetrospective cohort study of hospital records.SettingTertiary care public hospital in northern Italy.Participants11 052 patients aged >18 years, consecutively admitted to the ER in 1 year, and for whom BCDC collection was indicated by ER medical staff at first presentation.Primary outcomeSurvival was the referral outcome for explorative model development. Automated BCDC analysis at baseline assessed haemoglobin, mean cell volume (MCV), red cell distribution width (RDW), platelet distribution width (PDW), platelet haematocrit (PCT), absolute red blood cells, white blood cells, neutrophils, lymphocytes, monocytes, eosinophils, basophils and platelets. Discretisation cut-offs were defined by benchmark and tailored methods. Benchmark cut-offs were stated based on laboratory reference values (Clinical and Laboratory Standards Institute). Tailored cut-offs for linear, sigmoid-shaped and U-shaped distributed variables were discretised by maximally selected rank statistics and by optimal-equal HR, respectively. Explanatory variables (age, gender, ER admission during SARS-CoV2 surges and in-hospital admission) were analysed using Cox multivariable regression. Receiver operating curves were drawn by summing the Cox-significant variables for each method.ResultsOf 11 052 patients (median age 67 years, IQR 51–81, 48% female), 59% (n=6489) were discharged and 41% (n=4563) were admitted to the hospital. After a 306-day median follow-up (IQR 208–417 days), 9455 (86%) patients were alive and 1597 (14%) deceased. Increased HRs were associated with age >73 years (HR=4.6, 95% CI=4.0 to 5.2), in-hospital admission (HR=2.2, 95% CI=1.9 to 2.4), ER admission during SARS-CoV2 surges (Wave I: HR=1.7, 95% CI=1.5 to 1.9; Wave II: HR=1.2, 95% CI=1.0 to 1.3). Gender, haemoglobin, MCV, RDW, PDW, neutrophils, lymphocytes and eosinophil counts were significant overall. Benchmark-BCDC model included basophils and platelet count (area under the ROC (AUROC) 0.74). Tailored-BCDC model included monocyte counts and PCT (AUROC 0.79).ConclusionsBaseline discretised BCDC provides meaningful insight regarding ER patients’ survival.

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Parameters of the complete blood count predict in hospital mortality

Cited by 7 publications

References 37 publications

The presence of a urinary catheter is an important predictor of in‐hospital mortality in internal medicine patients

The presence of a urinary catheter is an important predictor of in‐hospital mortality in internal medicine patients

Hypochromic red blood cells is an independent measure of patient frailty

Blood cell differential count discretisation modelling to predict survival in adults reporting to the emergency room: a retrospective cohort study

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