Lymphocyte-to-white blood cells ratio in older patients experiencing a first acute heart failure hospitalization
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Low lymphocyte counts are related to poor health results in heart failure (HF) patients. We assess whether a low lymphocyte-to-white blood cells ratio (LWR) is related to 1-year mortality in older patients experiencing a first hospitalization for acute HF.
We evaluated 859 patients > 75 years of age admitted within a 33-month period because of a first episode of acute HF. Patients were divided into four groups according to LWR quartiles.
Patients’ mean age was 83.5 ± 5.5 years and their median LWR was 16.7%. After 1 year of follow-up 270 patients (31.43%) died. Mean LWR values were significatively lower in the group of patients who died (15.1 vs. 17.4%; p = 0.001). Mortality rates were significantly higher in the lower LWR quartile either at 1 month, 3 months, and 1 year after the index acute HF episode. The univariate logistic regression analysis identified the LWR (either as quartiles or continuous variable) to be independently associated with higher risk of 1-year post-discharge mortality. Multivariate analysis confirmed this association (HR for LWR as a quartiles variable 1.525; 95% CI 1.161–2.003 and for LWR as a continuous variable 1.145; 95% CI 1.069–1854) besides older age, a higher comorbidity and higher admission potassium.
As is the case in other HF scenarios, a simple routine admission laboratory test such as lymphocyte count can independently predict 1-year mortality for older patients hospitalized for first time due to acute HF.
KeywordsHeart failure Lymphocyte Hospitalization Older Mortality
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study conformed to the principles outlined in the Declaration of Helsinki and the ethics committee of the Bellvitge Universitari Hospital approved the overall protocol [PR2016/16].
For this type of study formal consent is not required.