Blood cell counts as a source of evidence for prognostic information in patients with acute heart failure: findings from a large, single-centre study
Notice bibliographique
Résumé
Abstract Background Inflammatory processes are increasingly recognised as pivotal in the pathophysiology of heart failure (HF) and several inflammatory biomarkers have emerged as potential tools for predicting adverse outcomes in patients with chronic HF. Red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR) are easy to obtain, inexpensive and rapidly available through routine blood tests. Their combined assessment may represent a valuable tool for predicting prognosis in the context of acute heart failure (AHF). Aims To assess the prognostic utility of RDW, NLR, MLR and PLR in a cohort of inpatients with AHF. Methods In this single-centre, observational study, data from patients admitted to our hospital between 1st January 2016 and 31st December 2023 were retrospectively collected. AHF was diagnosed according to the updated European Society of Cardiology guidelines. RDW, NLR, MLR and PLR measurements were considered elevated if values exceeded 14.6%, 2, 0.4 and 137, respectively. Participants were stratified into five cohorts according to the number of increased biomarkers reported (none, 1, 2, 3, or 4). Baseline characteristics and echocardiographic measurements were assessed for each group. Independent predictors of RDW, NLR, MLR and PLR were identified using linear regression analysis and the association between different cohorts and outcomes was assessed using Cox proportional hazards analysis. The outcomes were the composite of all-cause mortality or readmission due to heart failure (HF) and all-cause mortality at 90 days after discharge. Results A total of 8,127 patients, aged 81 years, of whom 4,312 (53%) men, were enrolled. Only 260 (3%) participants had normal biomarker levels, while 1,031 (13%), 1,717 (21%), 2,654 (33%) and 2,465 (30%) had 1, 2, 3 or all biomarkers elevated, respectively. Patients with higher biomarker levels were older, more likely to be male, had a higher prevalence of diabetes and hypertension and exhibited greater N-terminal pro-brain natriuretic peptide (NT-proBNP) measurements. RDW, NLR, MLR and PLR were found to be independent predictors of the composite outcome of all-cause mortality or rehospitalisation due to HF, as well as all-cause mortality. Compared with the cohort of patients with all normal biomarkers, those with increased biomarker levels presented a greater risk of developing adverse events, both in univariate and multivariate analyses. Conclusions RDW, NLR, MLR and PLR are frequently elevated in patients diagnosed with acute HF. Each biomarker independently predicts adverse events and their combination may be adopted as a valid tool to provide prognostic information.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,018 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».