Correlation between the white blood cell/platelet ratio and 28-day all-cause mortality in cardiac arrest patients: a retrospective cohort study based on machine learning
ObjectiveThis study aims to evaluate the association between the white blood cell-to-platelet ratio (WPR) and 28-day all-cause mortality among patients experiencing cardiac arrest.MethodsUtilizing data from 748 cardiac arrest patients in the Medical Information Mart for Intensive Care-IV (MIMIC-IV)...
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| Language: | English |
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1527664/full |
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| author | Huai Huang Guangqin Ren Shanghui Sun Zhi Li Yongtian Zheng Lijuan Dong Shaoliang Zhu Xiaosheng Zhu Wenyu Jiang |
| author_facet | Huai Huang Guangqin Ren Shanghui Sun Zhi Li Yongtian Zheng Lijuan Dong Shaoliang Zhu Xiaosheng Zhu Wenyu Jiang |
| author_sort | Huai Huang |
| collection | DOAJ |
| description | ObjectiveThis study aims to evaluate the association between the white blood cell-to-platelet ratio (WPR) and 28-day all-cause mortality among patients experiencing cardiac arrest.MethodsUtilizing data from 748 cardiac arrest patients in the Medical Information Mart for Intensive Care-IV (MIMIC-IV) 2.2 database, machine learning algorithms, including the Boruta feature selection method, random forest modeling, and SHAP value analysis, were applied to identify significant prognostic biomarkers. Key patient characteristics, encompassing demographic data, comorbidities, hematological and biochemical indices, and vital signs, were extracted using PostgreSQL Administration Tool (pgAdmin) software. The Cox proportional hazards model assessed the impact of WPR on mortality outcomes, while Kaplan-Meier survival curves and restricted cubic spline (RCS) analysis further validated the findings. Subgroup analyses stratified the prognostic value of WPR by demographic and clinical factors.ResultsWPR demonstrated the highest prognostic significance among the variables studied, showing a strong association with 28-day all-cause mortality. In the unadjusted Model 1, hazard ratios (HRs) for WPR quartiles ranged from 1.88 (95% CI: 1.22–2.90) in Q2 to 3.02 (95% CI: 2.04–4.47) in Q4 (Ptrend <0.05). Adjusted models (Models 2–4) confirmed the robustness of these associations, even after accounting for demographic and clinical covariates. Kaplan-Meier and RCS analyses revealed a significant U-shaped relationship between WPR and mortality risk. Subgroup analyses indicated that elevated WPR was particularly associated with increased mortality in males, elderly patients, married individuals, and those with chronic pulmonary disease.ConclusionWPR serves as an independent and reliable prognostic biomarker for 28-day mortality in cardiac arrest patients. Its integration into clinical decision-making may enhance the early identification of high-risk patients and guide tailored therapeutic interventions. |
| format | Article |
| id | doaj-art-fb9d25727fe94e9d939440c9bf4b7494 |
| institution | Kabale University |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-fb9d25727fe94e9d939440c9bf4b74942025-01-07T05:23:45ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-01-011510.3389/fphar.2024.15276641527664Correlation between the white blood cell/platelet ratio and 28-day all-cause mortality in cardiac arrest patients: a retrospective cohort study based on machine learningHuai Huang0Guangqin Ren1Shanghui Sun2Zhi Li3Yongtian Zheng4Lijuan Dong5Shaoliang Zhu6Xiaosheng Zhu7Wenyu Jiang8Department of Neurological Rehabilitation, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, ChinaDepartment of Anesthesiology, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, ChinaDepartment of Nursing, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, ChinaDepartment of Nursing, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, ChinaDepartment of Endocrinology, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, ChinaDepartment of Nursing, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, ChinaDepartment of Hepatobiliary, Pancreas and Spleen Surgery, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, ChinaDepartment of Radiation, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, ChinaDepartment of Neurological Rehabilitation, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, ChinaObjectiveThis study aims to evaluate the association between the white blood cell-to-platelet ratio (WPR) and 28-day all-cause mortality among patients experiencing cardiac arrest.MethodsUtilizing data from 748 cardiac arrest patients in the Medical Information Mart for Intensive Care-IV (MIMIC-IV) 2.2 database, machine learning algorithms, including the Boruta feature selection method, random forest modeling, and SHAP value analysis, were applied to identify significant prognostic biomarkers. Key patient characteristics, encompassing demographic data, comorbidities, hematological and biochemical indices, and vital signs, were extracted using PostgreSQL Administration Tool (pgAdmin) software. The Cox proportional hazards model assessed the impact of WPR on mortality outcomes, while Kaplan-Meier survival curves and restricted cubic spline (RCS) analysis further validated the findings. Subgroup analyses stratified the prognostic value of WPR by demographic and clinical factors.ResultsWPR demonstrated the highest prognostic significance among the variables studied, showing a strong association with 28-day all-cause mortality. In the unadjusted Model 1, hazard ratios (HRs) for WPR quartiles ranged from 1.88 (95% CI: 1.22–2.90) in Q2 to 3.02 (95% CI: 2.04–4.47) in Q4 (Ptrend <0.05). Adjusted models (Models 2–4) confirmed the robustness of these associations, even after accounting for demographic and clinical covariates. Kaplan-Meier and RCS analyses revealed a significant U-shaped relationship between WPR and mortality risk. Subgroup analyses indicated that elevated WPR was particularly associated with increased mortality in males, elderly patients, married individuals, and those with chronic pulmonary disease.ConclusionWPR serves as an independent and reliable prognostic biomarker for 28-day mortality in cardiac arrest patients. Its integration into clinical decision-making may enhance the early identification of high-risk patients and guide tailored therapeutic interventions.https://www.frontiersin.org/articles/10.3389/fphar.2024.1527664/fullcardiac arrest (CA)cardiopulmonary resuscitation (CPR)white blood cell to platelet ratio (WPR)8-day all-cause mortalityprognosis |
| spellingShingle | Huai Huang Guangqin Ren Shanghui Sun Zhi Li Yongtian Zheng Lijuan Dong Shaoliang Zhu Xiaosheng Zhu Wenyu Jiang Correlation between the white blood cell/platelet ratio and 28-day all-cause mortality in cardiac arrest patients: a retrospective cohort study based on machine learning Frontiers in Pharmacology cardiac arrest (CA) cardiopulmonary resuscitation (CPR) white blood cell to platelet ratio (WPR) 8-day all-cause mortality prognosis |
| title | Correlation between the white blood cell/platelet ratio and 28-day all-cause mortality in cardiac arrest patients: a retrospective cohort study based on machine learning |
| title_full | Correlation between the white blood cell/platelet ratio and 28-day all-cause mortality in cardiac arrest patients: a retrospective cohort study based on machine learning |
| title_fullStr | Correlation between the white blood cell/platelet ratio and 28-day all-cause mortality in cardiac arrest patients: a retrospective cohort study based on machine learning |
| title_full_unstemmed | Correlation between the white blood cell/platelet ratio and 28-day all-cause mortality in cardiac arrest patients: a retrospective cohort study based on machine learning |
| title_short | Correlation between the white blood cell/platelet ratio and 28-day all-cause mortality in cardiac arrest patients: a retrospective cohort study based on machine learning |
| title_sort | correlation between the white blood cell platelet ratio and 28 day all cause mortality in cardiac arrest patients a retrospective cohort study based on machine learning |
| topic | cardiac arrest (CA) cardiopulmonary resuscitation (CPR) white blood cell to platelet ratio (WPR) 8-day all-cause mortality prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1527664/full |
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