Lymphocyte-to-white blood cells ratio in older patients experiencing a first acute heart failure hospitalization.

Abstract

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 > 75years 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 ± 5.5years and their median LWR was 16.7%. After 1year 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 1month, 3months, and 1year 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.