Title:The Association between Peripheral Blood Cells and the Frailty Syndrome in Patients with Cardiovascular Diseases
Volume: 20
Issue: 9
Author(s): Constantin Bodolea, Elisabeta I. Hiriscau*, Elena-Cristina Buzdugan, Alin I. Grosu, Laurențiu Stoicescu, Ștefan Vesa and Omar Cauli
Affiliation:
- ICU Department, ”Iuliu Hațieganu” University Clinical Municipal Hospital, Cluj-Napoca,Romania
Keywords:
Cardiovascular diseases, frailty, malnutrition, neutrophil-to-lymphocyte ratio, peripheral blood count, platelet-tolymphocyte
ratio, red blood cell distribution width, red cell distribution width-to-platelet ratio, white blood count.
Abstract:
Background: Frailty syndrome is characterized by multisystem dysregulation frequently
found in older individuals or even in younger patients with chronic disabling diseases such as cardiovascular
diseases.
Objective: To determine whether peripheral blood cell count, and its subpopulations, red blood cell and
platelets, morphology and different ratios (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio
and red blood distribution width-to-platelet ratio) are associated with cardiac frail patients, and through
this to improve the prediction of frailty status in patients with cardiovascular diseases.
Methods: An observational, retrospective, cohort study enrolling 179 patients with cardiovascular
disease divided into two groups: non-frail group (100 pts) and frail group (79 pts), a cohort detached
from the Frail.RO study. The frailty was evaluated based on the Fried criteria; haematological markers,
sociodemographic data, and variables related to cardiovascular diseases and comorbidities were also
recorded.
Results: Lower lymphocytes, platelet count, and neutrophil-to-lymphocyte ratio were significantly
associated with a more severe frailty syndrome. Regarding red blood cells, haemoglobin concentration
and red cell distribution width significantly correlated with the severity of the frailty syndrome. Receiver
operating characteristic curve analysis for these markers associated with the frailty syndrome
revealed an acceptable sensitivity of 66 % and specificity of 65% to identify frail individuals. Malnutrition
and hypercholesterolemia are relevant predictors for identifying frailty in hospitalized cardiovascular
patients.
Conclusion: The evaluation of peripheral blood cell composition routinely measured in clinical practice
can represent a valuable, but limited indicator, to diagnose frailty syndrome and eventually, the
effects of interventions in frail patients with cardiovascular diseases.