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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1527664
This article is part of the Research Topic Clinical Pharmacist Service Promotes the Improvement of Medical Quality Volume II View all 33 articles

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

Provisionally accepted
Huai Huang Huai Huang 1Guangqin Ren Guangqin Ren 2Shanghui Sun Shanghui Sun 2Xiaosheng Zhu Xiaosheng Zhu 3Zhi Li Zhi Li 2Yongtian Zheng Yongtian Zheng 2Linjuan Dong Linjuan Dong 2Shaoliang Zhu Shaoliang Zhu 4Wenyu Jiang Wenyu Jiang 3*
  • 1 Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Guangxi Medical University, Nanning, China
  • 2 Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, China
  • 3 Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Region, China
  • 4 Guangxi University, Nanning, Guangxi Zhuang Region, China

The final, formatted version of the article will be published soon.

    Objective: This 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.Utilizing 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.Results: WPR 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.WPR 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.

    Keywords: Cardiac arrest (CA), Cardiopulmonary resuscitation (CPR), White blood cell to platelet ratio (WPR), 8-Day All-Cause Mortality, Prognosis CA -Cardiac Arrest, CPR -Cardiopulmonary Resuscitation, WPR -White Blood Cell to Platelet Ratio, MIMIC-IV -Medical Information Mart for Intensive Care-IV

    Received: 13 Nov 2024; Accepted: 10 Dec 2024.

    Copyright: © 2024 Huang, Ren, Sun, Zhu, Li, Zheng, Dong, Zhu and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Wenyu Jiang, Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Region, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.