Version 1
: Received: 20 November 2023 / Approved: 20 November 2023 / Online: 20 November 2023 (07:53:38 CET)
How to cite:
Huang, H.; Huang, F.; Zhou, J.; Zhang, Z.; Ren, Y.; Chang, S.; Xue, J. Association of WBC Levels With All-Cause Mortality in ICU Patients Receiving CRRT: A Retrospective Cohort Study. Preprints2023, 2023111224. https://doi.org/10.20944/preprints202311.1224.v1
Huang, H.; Huang, F.; Zhou, J.; Zhang, Z.; Ren, Y.; Chang, S.; Xue, J. Association of WBC Levels With All-Cause Mortality in ICU Patients Receiving CRRT: A Retrospective Cohort Study. Preprints 2023, 2023111224. https://doi.org/10.20944/preprints202311.1224.v1
Huang, H.; Huang, F.; Zhou, J.; Zhang, Z.; Ren, Y.; Chang, S.; Xue, J. Association of WBC Levels With All-Cause Mortality in ICU Patients Receiving CRRT: A Retrospective Cohort Study. Preprints2023, 2023111224. https://doi.org/10.20944/preprints202311.1224.v1
APA Style
Huang, H., Huang, F., Zhou, J., Zhang, Z., Ren, Y., Chang, S., & Xue, J. (2023). Association of WBC Levels With All-Cause Mortality in ICU Patients Receiving CRRT: A Retrospective Cohort Study. Preprints. https://doi.org/10.20944/preprints202311.1224.v1
Chicago/Turabian Style
Huang, H., Sansi Chang and Jun Xue. 2023 "Association of WBC Levels With All-Cause Mortality in ICU Patients Receiving CRRT: A Retrospective Cohort Study" Preprints. https://doi.org/10.20944/preprints202311.1224.v1
Abstract
Background
Acute kidney injury (AKI) is a common comorbidity in the intensive care unit (ICU), with higher mortality rate among those who receive continuous renal replacement therapy (CRRT). This study aimed to investigate the association of white blood cell (WBC) levels with all-cause mortality in AKI patients undergoing CRRT.
Method
We conducted a post hoc analysis of ICU patient data from multiple centers in Korea. First, the levels of WBCs were classified into four groups based on quartiles. Second, the relationship between different WBC levels and mortality was investigated with the Kaplan-Meier (K-M) survival curves, Cox proportional hazards model, and generalized additivity model (GAM). Finally, we used multiple imputation to avoid bias caused by non-randomized missing data. The endpoints were short-term (28 days) and long-term (90 days) mortality.
Result
In our analysis, a total of 1,100 ICU patients were included. Among them, 670 (60.90%) and 781 (71.00%) died within 28 and 90 days, respectively. K-M survival curves showed that patients with the lowest WBC levels had the highest risk of mortality for both outcomes. Adjusted multivariate Cox regression analysis confirmed that compared with the reference level (quartile 2), low WBC levels increased the risk of both 28-day mortality (quartile 1, HR = 1.43, 95% CI: 1.13–1.83, P = 0.004) and 90-day mortality (quartile 1: HR = 1.32; 95% CI: 1.05-1.66, P = 0.016). GAM analysis showed a non-linear, U-shaped relationship between pre-CRRT WBC levels and all-cause mortality (non-linear P < 0.05).
Conclusion
The baseline WBC level is an independent predictor of prognosis for ICU patients receiving CRRT. Patients in the lowest WBC quartile had the highest risk of all-cause mortality. These results provide further evidence that early observation and intervention may have a prognostic value for these high-risk patients.
Keywords
acute kidney injury; continuous renal replacement therapy; intensive care unit; cox regression; prediction model
Subject
Medicine and Pharmacology, Clinical Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
