Preview

Сибирский научный медицинский журнал

Advanced search

The role of hematological parameters as predictors of mortality in elderly patients in the hospital period

https://doi.org/10.15372/SSMJ20200609

Abstract

The development of algorithms for predicting adverse outcomes, including death in elderly and senile patients, is an urgent issue. Potential predictors include hematologic parameters. A clinical blood test is one of the most affordable diagnostic methods in practical medicine, reflecting systemic pathological processes in the human body based on a quantitative assessment of the cellular composition and blood morphology. The aim of this study was to evaluate hematological parameters as predictors of in-hospital mortality in patients of the elderly and senile age with acute coronary syndrome.

Material and methods. The study included 277 patients with acute coronary syndrome. The study of hematological parameters was carried out on a CELL-DYN Sapphire hematology analyzer (Abbott Laboratories, USA). The values of neutrophil-lymphocytes ratio and platelet-lymphocytes ratio were also evaluated as predictors of in-hospital mortality.

Results. High content of leukocytes (above 10.45 x 109/l) during hospitalization in patients with ACS aged 60-74 years are associated with a higher risk of death at the hospital stage. Among patients with ACS aged 75-89 years, the risk of death is associated with the following changes in peripheral blood upon admission: a decrease in the absolute number of eosinophils below 0.086 x 109/l, an increase in the absolute number of basophils above 0.079 x 109/l and a decrease in platelet-lymphocytes ratio below 31.06.

About the Authors

L. V. Borisova
Saint-Petersburg Institute of Bioregulation and Gerontology; City multidisciplinary hospital № 2
Russian Federation

Lyudmila V. Borisova

St. Petersburg, Dinamo av., 3; St. Petersburg, Uchebnyj lane, 5



S. A. Rukavishnikova
City multidisciplinary hospital № 2; First Pavlov State Medical University of St. Petersburg of Minzdrav of Russia
Russian Federation

Svetlana A. Rukavishnikova - Doctor of Biological Sciences, Professor.

St. Petersburg, Uchebnyj lane, 5; St. Petersburg, Lev Tolstoy str., 6-8



A. S. Pushkin
Saint-Petersburg Institute of Bioregulation and Gerontology; City multidisciplinary hospital № 2; First Pavlov State Medical University of St. Petersburg of Minzdrav of Russia
Russian Federation

Alexander S. Pushkin - Candidate of Medical Sciences.

St. Petersburg, Dinamo av., 3; St. Petersburg, Uchebnyj lane, 5; St. Petersburg, Lev Tolstoy str., 6-8



T. A. Ahmedov
City multidisciplinary hospital № 2; First Pavlov State Medical University of St. Petersburg of Minzdrav of Russia
Russian Federation

Timur A. Akhmedov - Candidate of Medical Sciences.

St. Petersburg, Uchebnyj lane, 5; St. Petersburg, Lev Tolstoy str., 6-8



V. V. Yakovlev
Military medical Academy of S.M. Kirov
Russian Federation

Vladimir V. Yakovlev - Doctor of Medical Sciences.

St. Petersburg, Akademik Lebedev str., 6



References

1. Belialov F.I. Risk prediction scores of diseases. Kompleksnyye problemy serdechno-sosudistykh zabolevaniy = Complex Issues of Cardiovascular Diseases. 2018; 7 (1): 84-93. [In Russian]. doi: 10.17802/23061278-2018-7-1-84-93

2. Niu X., Liu G., Huo L., Zhang J., Bai M., Peng Y., Zhang Z. Risk stratification based on components of the complete blood count in patients with acute coronary syndrome: A classification and regression tree analysis. Sci. Rep. 2018; 8 (1): 2838. doi: 10.1038/s41598-018-21139-w

3. Roffi M., Patrono C., Collet J.P., Mueller C., Valgimigli M., Andreotti F., Bax J.J., Borger M.A., Brotons C., Chew D.P., Gencer B., Hasenfuss G., Kjeldsen K., Lancellotti P., Landmesser U., Mehilli J., Mukherjee D., Storey R.F., Windecker S., ESC Scientific Document Group. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology. European Heart Journal. 2016; 37: 267-315. doi: 10.1093/eurheartj/ehv320

4. Ibanez B., James S., Agewall S., Antunes M., Bucciarelli-Ducci C., Bueno H., Caforio A., Crea F., Goudevenos J., Halvorsen S., Hindricks G., Kastrati A., Lenzen M., Prescott E., Roffi M., Valgimigli M., Varen-horst C., Vranckx P, Widimsky P 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology. Eur. Heart J. 2018; 39: 119-177. doi:10.1093/eurheartj/ehx393

5. Borel’ K.N. Prognozirovanie serdechno-sosudistykh sobytii u patsientov trudosposobnogo vozrasta, perenesshikh infarkt miokarda (po dannym pospektivnogo 5-letnego kliniko-epidemiologicheskogo issle-dovaniya). Abstract of thesis. . cand. med. sciences. 2015. [In Russian].

6. Koval’chuk E.Yu., Soroka V.V. Sovremennyi kliniko-epidemiologicheskii portret patsienta s ostrym infarktom miokarda (po materialam regional’nogo sosudistogo tsentra). Uchenyye zapiski Sankt-Peterburgskogo gosudarstvennogo meditsinskogo universiteta imeni akademika Ivana Petrovicha Pavlova = The Scientific Notes of the I.P. Pavlov St. Petersburg State Medical University. 2015; 22 (2): 56-60. [In Russian].

7. Hung J., Teng T.K., Finn J., Knuiman M., Brif-fa T., Stewart S., Sanfilippo F.M., Ridout S., Hobbs M. Trends from 1996 to 2007 in incidence and mortality outcomes of heart failure after acute myocardial infarction: a population-based study of 20812 patients with first acute myocardial infarction in Western Australia. JAHA. 2013; 2 (5): 1-9. doi: 10.1161/JAHA.113.000172

8. Kim R.B., Kim B., Kim Y.M., Seo J.W., Lim Y.S., Kim H.S., Lee H.J., Moon J.Y., Kim K.Y., Shin J.Y., Park H.K., Song J.K., Park K.S., Jeong B.G.,. Park C.G, Shin H.Y., Kang J.W., Oh G.J., Lee Y.H., Seong I.W., Yoo W.S., Hong Y.S. Trends in the incidence of hospitalized acute myocardial infarction and stroke in Korea, 2006-2010. J. Korean Med. Sci. 2013; 28 (1): 16-24. doi: 10.3346/jkms.2013.28.1.16

9. Schmidt M., Jacobsen J.B., Lash T.L., B0tker H.E., S0rensen H.T. 25-year trends in first time hospitalization for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: a Danish nationwide cohort study. BMJ. 2012; 344: e356. doi: 10.1136/bmj.e356

10. Grzybowski M., Welch R.D., Parsons L., Ndumele C.E., Chen E., Zalenski R., Barron H.V. The association between white blood cell count and acute myocardial infarction in-hospital mortality: findings from the National Registry of Myocardial Infarction. Acad. Emerg. Med. 2004; 11 (10): 1049-1060. doi: 10.1197/j.aem.2004.06.005

11. Tamhane U.U., Aneja S., Montgomery D., Rogers E., Eagle K.A., Gurm H.S. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am. J. Cardiol. 2008; 102 (6): 653-657. doi: 10.1016/j.am-jcard.2008.05.006.

12. Suliman M.A.R.M., Juma A.A.B., Almadhani A.A.A., Pathare A.V., Alkindi S.S.A., Werner F.U. Predictive value of neutrophil to lymphocyte ratio in outcomes of patients with acute coronary syndrome. Arch. Med. Res. 2010; 41: 618-622. doi: 10.1016/j.arc-med.2010.11.006

13. Suliman M.M.A., Juma A.A.B., Ali Almadhani A.A., Pathare A.V., Alkindi S.S.A., Werner F.U. Predictive value of neutrophil to lymphocyte ratio in outcomes of patients with acute coronary syndrome. Arch. Med. Res. 2010; 41: 618-622. doi: 10.1016/j.arc-med.2010.11.006

14. Azab B., Shah N., Akerman M., McGinn J.T.Jr. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J. Thromb. Thrombolys. 2012; 34 (3): 326334. doi: 10.1007/s11239-012-0718-6

15. Azab B., Zaher M., Weiserbs K.F., Torbey E., Lacossiere K., Gaddam S., Gobunsuy R., Jadonath S., Baldari D., McCord D., Lafferty J. Usefulness of neutrophil to lymphocyte ratio in predicting short-and long-term mortality after non-ST-elevation myocardial infarction. Am. J. Cardiol. 2010; 106 (4): 470-476. doi: 10.1016/j.amjcard.2010.03.062

16. Pan W., Zhao D., Zhang C., Li W., Yu J., Wang S., Li Z., Wang Z., Sun X., Liu H., Sun Y., Tian Y., Wang L. Application of neutrophil/lymphocyte ratio in predicting coronary blood flow and mortality in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention. J. Cardiol. 2015; 66 (1); 9-14. doi: 10.1016/j.jjcc.2014.10.014

17. Mesri M., Altieri D.C. Endothelial cell activation by leukocyte microparticles. J. Immunol. 1998; 161 (8): 4382-4387.

18. Thomson S.P., Gibbons R.J., Smars P.A., Su-man V.J., Pierre R.V., Santrach P.J., Jiang N.S. Incremental value of the leukocyte differential and the rapid creatine kinase-MB isoenzyme for the early diagnosis of myocardial infarction. Ann. Intern. Med. 1995; 122 (5): 335-341. doi: 10.7326/0003-4819-122-5199503010-00003

19. Konishi T., Funayama N., Yamamoto T., Morita T., Hotta D., Nishihara H., Tanaka S. The prognostic value of eosinophil to leukocyte ratio in patients presenting with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. J. Atheroscler Thromb. 2017; 24 (8): 827-840. doi: 10.5551/jat.37937

20. Toor I.S., Jaumdally R., Lip G.Y.H., Millane T., Varma C. Eosinophil count predicts mortality following percutaneous coronary intervention. Thromb. Res. 2012; 130 (4): 607-611. doi: 10.1016/j.thromres.2012.05.033

21. Rios-Navarro C., Gavara J., Vidal V., Racug-no P., Bayes-Genis A., Minana G., Husser O., Oltra R., Nunez J., Chorro F.J., Bobi V., Ruiz-Sauri A. Characterization and implications of the dynamics of eosinophils in blood and in the infarcted myocardium after coronary reperfusion. PloS One. 2018; 13 (10): 1-20. doi: 10.1371/journal.pone.0206344

22. Jacobsen E.A., Taranova A.G., Lee N.A., Lee J.J. Eosinophils: singularly destructive effector cells or purveyors of immunoregulation? J. Allergy Clin. Immunol. 2007; 119 (6): 1313-1320. doi: 10.1016/j.jaci.2007.03.043

23. Pinegina N.V. Leukocyte-platelet complexes in the pathogenesis of acute coronary syndrome. Part 1. Kreativnaya kardiologiya = Creative Cardiology. 2016; 10 (2): 128-135. [In Russian]. doi: 10.15275/kreatkard.2016.02.03

24. Al-Obeidi S.R.H. Ahmedm S., Obeid F.A. Evaluation of platelet indices in patients with acute coronary syndrome. Mustansiriya Med. J. 2013; 12 (1): 58-64.

25. Varastehravan H.R., Ali-Hassan-Sayegh S., Shokraneh S., Mozayan M.R., Karimibondarabadi A.A. Relationship of admission mean platelet volume, platelet distribution width and white blood cells with ST resolution in patients with acute ST segment elevation myocardial infarction treated with streptokinase without history of previous cardiovascular surgery. Perspect. Clin. Res. 2013; 4 (2): 125-129. doi: 10.4103/2229-3485.111792

26. El-Dosouky I.I., Shehata I.E. Value of the mean platelet volume in evaluation of patients with acute coronary syndrome. J. Med. Diagn. Meth. 2016; 5 (1): 1-5. doi: 10.4172/2168-9784.1000201

27. Wang J., Li X., Pu J., Jin S., Jia L., Li X., Liu F., Yang Y. Mean platelet volume and coronary plaque vulnerability: an optical coherence tomography study in patients with non-ST-elevation acute coronary syndrome. BMC Cardiovasc. Disord. 2019; 19 (1): 128. doi: 10.1186/s12872-019-1115-2

28. Crea F., Libby P. Acute coronary syndromes: the way forward from mechanisms to precision treatment. Circulation. 2017; 136: 1155-1166. doi: 10.1161/CIRCULATIONAHA.117.029870

29. Zhao N., Mi L., Liu X., Pan S., Xu J., Xia D., Liu Z., Zhang Y., Xiang Y., Yuan Z., Guan G., Wang J. Combined value of red blood cell distribution width and Global Registry of Acute Coronary Events risk score for predicting cardiovascular events in patients with acute coronary syndrome undergoing percutaneous coronary intervention. PLoS One. 2015; 10 (1): e0140532. doi: 10.1371/journal.pone.0140532

30. Correia L.C., Souza A.C., Sabino M., Brito M., Maraux M., Garcia G., Esteves J.P., Noya-Rabelo M.M. Hemoglobin level adds prognostic value to the Global Registry of Acute Coronary Events score in non-ST elevation acute coronary syndromes. Cardiology. 2012; 121: 213-219. doi: 10.1159/000336954


Review

For citations:


Borisova L.V., Rukavishnikova S.A., Pushkin A.S., Ahmedov T.A., Yakovlev V.V. The role of hematological parameters as predictors of mortality in elderly patients in the hospital period. Сибирский научный медицинский журнал. 2020;40(6):89-98. (In Russ.) https://doi.org/10.15372/SSMJ20200609

Views: 257


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2410-2512 (Print)
ISSN 2410-2520 (Online)