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    Leukocytosis and adverse hospital outcomes after acute myocardial infarction

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    Authors
    Menon, Vandana
    Lessard, Darleen M.
    Yarzebski, Jorge L.
    Furman, Mark I.
    Gore, Joel M.
    Goldberg, Robert J.
    UMass Chan Affiliations
    Department of Medicine, Division of Cardiovascular Medicine
    Document Type
    Journal Article
    Publication Date
    2003-08-14
    Keywords
    Aged
    Cardiac Output, Low
    Female
    *Hospital Mortality
    Humans
    Leukocyte Count
    Leukocytosis
    Male
    Middle Aged
    Multivariate Analysis
    Myocardial Infarction
    Odds Ratio
    Prognosis
    Risk Factors
    Shock, Cardiogenic
    Bioinformatics
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1016/S0002-9149(03)00651-9
    Abstract
    An elevated white blood cell (WBC) count at the time of hospital presentation is associated with increased mortality after acute myocardial infarction (AMI). The association between WBC count and the development of clinically significant complications of AMI and death during hospitalization for AMI is, however, less clear. The objectives of this observational study were to examine the association between baseline WBC count, the development of heart failure, cardiogenic shock, and death during hospitalization for AMI from a more generalizable community-wide perspective. The study sample consisted of adult residents of all ages from the Worcester, Massachusetts, metropolitan area (1990 census estimate 437,000) hospitalized with confirmed AMI at all greater Worcester medical centers. The study population consisted of 3,796 men and 2,734 women of all ages hospitalized with validated AMI, in 12 annual periods between 1986 and 1999, aggregated into quintiles based on WBC count obtained at the time of hospital admission. In multivariable-adjusted regression analyses controlling for potentially confounding demographic and clinical factors, patients in the uppermost quintiles of WBC count were at increased risk for heart failure (odds ratio [OR] 2.77, 95% confidence interval [CI] 2.33 to 3.31), cardiogenic shock (OR 2.82, 95% CI 2.05 to 3.87), and hospital death (OR 2.14, 95% CI 1.66 to 2.76). The results of our large observational study suggest that the peripheral total leukocyte count is strongly associated with the development of heart failure, cardiogenic shock, and death during hospitalization for AMI. These findings suggest that the WBC count should be considered an important prognostic factor associated with adverse hospital outcomes in patients with AMI.
    Source
    Am J Cardiol. 2003 Aug 15;92(4):368-72.
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47167
    PubMed ID
    12914863
    Related Resources
    Link to Article in PubMed
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    Population and Quantitative Health Sciences Publications

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