Heart failureUtility of the Neutrophil to Lymphocyte Ratio in Predicting Long-Term Outcomes in Acute Decompensated Heart Failure
Section snippets
Methods
The study population (n = 1,212) included consecutive patients admitted (from January 2006 to December 2008) with diagnoses of ADHF to the New England Heart Institute at Catholic Medical Center, a large urban hospital in Manchester, New Hampshire. The diagnosis of ADHF was based on standard guidelines.12 Patients with medical conditions known to affect the total and differential WBC counts, such as disorders of the hematopoietic system, history of cancer and/or previous treatment with
Results
Of the total of 1,296 consecutive patients admitted to our institution with ADHF during the study duration, 84 patients were excluded because they did not meet the inclusion criteria, and thus 1,212 patients became eligible for the study. The baseline characteristics of the study population according to NLR tertile are listed in Table 1. Membership in the higher NLR tertile was associated with older age, female gender, systemic hypertension, diabetes mellitus, history of coronary artery
Discussion
The primary finding of this study is that higher NLR tertile is associated with increased risk for mortality in patients admitted with ADHF. Furthermore, the predictive ability of NLR was superior to those of neutrophil count, total WBC count, and relative low lymphocyte count for mortality in patients admitted with ADHF. Additional analysis revealed that higher NLR tertile was associated with increased risk for 30-day ADHF-related readmission and increased mortality irrespective of LVEF.
Acknowledgment
We acknowledge the invaluable assistance of Cynthia David, MLS, MPS, and Revathi Hariram, BS.
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