Usefulness of a complete blood count-derived risk score to predict incident mortality in patients with suspected cardiovascular disease.

Full Abstract

The complete blood cell (CBC) count is an inexpensive, frequently obtained blood test whose information content is potentially underused. We examined the predictive ability of the CBC count for incident death in 29,526 consecutive consenting patients who underwent coronary angiography. Subjects were randomly assigned to training (60%) and test (40%) groups and were followed for an average of 4.9 years. Computed and integer risk score models for all-cause death were developed for 30 days and 1, 5, and 10 years using multivariable logistic regressions applied to CBC metrics, age, and gender. The study cohort was an average age of 61 years, 62% were men, and had a 3.3% annual risk of mortality. An integer (scalar) risk score (range 0 to 18) successfully separated patient cohorts into subgroups at markedly different mortality risks (<1% to >14% at 30 days). Predictive fractions (area under risk curve) at 30 days for the CBC-only model and the age- and gender-adjusted CBC model were 0.76 and 0.78, respectively, in the training set and 0.71 and 0.75, respectively, in the test set (all p values <<0.001). The CBC model was markedly more informative than models based only on hematocrit, white blood cell count, or age and gender and was superior to models with all 7 traditional risk factors. In conclusion, in a large, prospectively assembled database, a CBC risk model had high predictive ability for risk of incident mortality. A total CBC score is an important new addition to risk prediction, and it can be easily generated by computer for clinical use at negligible incremental cost.

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Author information

Author/s: Anderson, Jeffrey L (JL); Ronnow, Brianna S (BS); Horne, Benjamin D (BD); Carlquist, John F (JF); May, Heidi T (HT); Bair, Tami L (TL); Jensen, Kurt R (KR); Muhlestein, Joseph B (JB); Intermountain Heart Collaborative (IHC) Study Group;

Affiliation: Cardiovascular Department, LDS Hospital, and University of Utah, Salt Lake City, Utah, USA. jeffrey.anderson(-atsign-)intermountainmail.org

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: The American journal of cardiology (Am J Cardiol), published in United States. (Language: eng)

Reference: 2007-Jan; vol 99 (issue 2) : pp 169-74

Dates: Created 2007/01/15; Completed 2007/02/27;

PMID: 17223413, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Age Factors
Blood Cell Count
Cardiovascular Diseases - blood; mortality
Female
Follow-Up Studies
Humans
Male

Middle Aged
Prospective Studies
Risk Assessment - methods
Sex Factors
Survival Rate - trends
Time Factors
United States - epidemiology

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