The Prognostic Value of Complete Blood Count among Patients with Acute Decompensated Heart Failure

Abstract

Heart failure (HF) is fraught with a poor outcome despite advances in its therapy. Therefore, risk stratification of patients with HF patients with easy to measure indices such as complete blood count is important to direct targeted areas of research and therapies that may favorably alter the outcome of HF patients. Hypothesis: Lymphopenia may be a surrogate marker of HF severity as it occurs secondary to splanchnic congestion with resultant direct enteric loss of lymphocytes. Racial differences may play a role in predicating outcomes among patients with HF indicating the effect of genes. Adherence to guideline directed medical therapy should reduce readmission rates among patients with HF. Methods: Retrospective cohort study of 191 patients admitted for HF over a period of 10 years. Patients 18 years and older admitted for acute decompensated HF (ADHF) were included. Patients with documented infection, hematologic and non-hematologic malignancies, advanced renal failure were excluded. Complete blood counts as well as other parameters were recorded at the time of admission for all the study participants. Data analysis was carried out using IBM SPSS software version 24.0.Relevant statistics were applied to establish the objectives of this study. The level of significance was set at a p value of less than 0.05 and confidence interval of 95%. Results: The study was made up of 51 females and 140 males with age ranging from 27 to 96 years. Of the 191 patients with ADHF, 13 of them were re-hospitalized within 30 days while 52 of them were re-hospitalized within 6 months of discharge. After regression analysis, nonblacks (p\u202f=\u202f0.036) had lower risk of re-hospitalization in 6 months. Lymphopenia (P =0.022) and infrequent use of beta blockers (P\u202f=\u202f0.042) increased readmission within 6 months. After univariate analysis, the patients readmitted within 30 days post discharge had lower body mass index, lower hemoglobin, lymphopenia, higher leucocyte count and higher total bilirubin levels. However, after regression analysis, none of these were predictive of 30-day readmission. Conclusions: Lymphopenia may be one of the most potent hematological markers to predict readmission within 6 months. Black race and infrequent use of beta blockers predict readmission within 6 months. Genetics may play a role in outcomes among patients with ADHF