Utility of Complete Blood Picture for Predicting In-hospital Mortality in Patients with Acute Decompensated Heart Failure with Dilated Cardiomyopathy

Background Congestive heart failure (CHF) is one of the leading causes of acute hospital admissions. Despite recent advances in heart failure therapy, prognosis is still poor, rehospitalization rate is very high, and quality of life is worse. It is important to identify patients at increased risk of adverse events. We tried to investigate role of components of complete blood picture on in-hospital mortality in patients hospitalized with heart failure. Methods It was an observational study of consecutive patients who admitted with a diagnosis of acute decompensated heart failure (ADHF) with dilated cardiomyopathy (DCM) in the our department between January 1, 2016 and December 31, 2016, age above 18 years. Ischemic cardiomyopathy was ruled by doing coronary angiograms either in this admission or previously known. Baseline investigations including complete blood picture were done and the patients were followed up till discharge or in hospital mortality. Results A total of 74 patients (female:male::24:50) enrolled into the study (mean age 51.86 ± 13.5 years) in 12 months. A total of 8 (10.8%) patients died during hospitalization. Among the 74 heart failure patients, 24 (32.5%) had anemia. Group 1 included patients who died during index hospitalization (n = 8) and group 2 comprised patients who were discharged in a stable condition after index hospitalization (n = 66). Group 1 patients had low hemoglobin (12.34 ± 2.93 vs. 14.4 ± 0.21 g/dL, p = 0.000) and high leukocyte count (11,600 ± 2,780 vs. 9,047 ± 3,355 cells/mcL, p = 0.040) with more eosinophils (1 ± 1.06 vs. 4.16 ± 3.48%, p = 0.000) and lymphocytes (20.5 ± 0.53 vs. 17.56 ± 7.45%, p = 0.002). Regression analysis showed a significant association between low hemoglobin and low packed cell volume (PCV) with in-hospital mortality. Mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) rather than mean corpuscular hemoglobin concentration (MCHC) predicted worse outcome. There was a significantly higher risk of in-hospital mortality with increasing eosinophil count. On the other hand, there was no association between platelet count, total white blood cell (WBC) count, neutrophil, monocyte, or lymphocyte count with clinical outcome. Conclusion Low hemoglobin, low PCV, and high eosinophil count have been shown to predict in-hospital mortality. Complete blood picture can, therefore, be utilized in risk-stratifying patients with ADHF due to DCM.