Evaluating the prognosis value of White Blood Count (WBC) count in Congestive Heart Failure (CHF)
Introduction: Congestive heart failure (CHF) is a condition of heart muscle weakness and ventricular dysfunction that leads to fatigue and dyspnea. Currently more than 5 million people are suffering from CHF worldwide. CHF includes wide range of symptoms and has different prognosis and treatments. There are so many prognostic factors for identifying high risk patients (such as age, left ventricular dysfunction and etc.) but lately researchers have focused on some new factors such as inflammatory markers, natriuretic peptide and leukocytosis. So in this study we aimed to evaluate prognostic effects of CBC findings specially WBC on prognosis of CHF during hospitalization and 6 months after discharge in CHF patients.
Method and materials: This retrospectitive cohort study was done in Rasoul Akram Hospital of Tehran September 2017 until September 2019. Information such as demographic ones (age and gender), CBC (WBC, HB, Platelets), blood sugar, TG & cholesterol, sodium and potassium in the first test after hospitalization were derived from the files and recorded in a standard check list.
The inclusion criteria consisted of age above 18 and the absolute diagnose of CHF. The exclusion criteria were trauma, surgery or co morbidities such as diabetes mellitus and hypertension. complications during hospitalization were defined as death in the hospital or hospitalization more than 5 days. Complications after 6 months of discharge were defined as death, readmitting to the hospital because of MI, Angina or heart attack and Need a kind of mechanical therapy such as pace maker. Statistical analyses were performed using Statistical software SPSS version 22. Statistical significance was considered at p < 0.05.
Results: 117 patients consisted of 53 women (45.3%) and 64 men (54.7%) were included in the study. The means and SD of age was 70±14. 65 patients (55.6%) of 117 ones suffered from hypertension and 48 patients (41%) had diabetes mellitus.
The means and SD of hemoglobin and hematocrit of patients were 11.6±2.1 and 36.1±6.,the amount of WBC, hemoglobin, hematocrites and platelets has no significant differences (P value>0.05) between short term and long term events.
Discussion: findings show that patients suffered from mild to moderate anemia. As shown in the previous studies, anemia is a common co morbidity with CHF. Anemia causes an increase in cardiac output, sympathetic activity, extracellular fluid and plasma. It worsens the symptoms, cause re hospitalization and increase in hospitalization period and treatment costs. Finally it causes CHF prognosis to get worse.
Some previous studies showed that low hemoglobin and hematocrit cause an increase in death within 30 days in AMI and ACS but findings of this study showed that there is no correlation between WBC count and CHF outcomes. Because of contradictory findings it seems necessary that more studies with huge samples be conducted.
Conclusion: WBC count has no correlation with CHF outcomes and it can not be used as a prognostic value.
Key words: WBC count- systolic heart failure- CHF
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