White Blood Counts of Hospitalized Patients Without Infection, Malignancy, or Immune Dysfunction

Area of Science:

• Clinical Medicine
• Hematology
• Laboratory Medicine

Background:

• Elevated white blood cell (WBC) counts can signal serious health issues like malignancy, infection, or immune dysfunction.
• Current diagnostic practices rely on reference ranges derived from healthy populations, which may not accurately reflect hospitalized patients.
• A specific reference range for WBC counts in hospitalized individuals without these conditions is currently lacking.

Purpose of the Study:

• To establish a normal reference range for white blood cell (WBC) counts in hospitalized patients.
• To identify factors influencing WBC counts in hospitalized patients without malignancy, infection, or immune dysfunction.

Main Methods:

• Retrospective cross-sectional study of 46,419 non-surgical hospitalized patients from 2017-2018.
• Collected data included white blood cell (WBC) count, absolute neutrophil count, and absolute lymphocyte count.
• Calculated means, standard deviations, and reference ranges for WBC counts.

Main Results:

• The normal reference range for WBC count in this cohort was determined to be 1.6-14.5 × 10^9 WBCs/L.
• Factors such as older age, Black race, and congestive heart failure were associated with lower WBC counts.
• Higher WBC counts were linked to increased body mass index, diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease, and steroid use.

Conclusions:

• The established normal WBC count range for hospitalized patients without infection, malignancy, or immune dysfunction is 1.6-14.5 × 10^9 WBCs/L.
• Physicians should consider patient demographics, comorbidities, and medication use when interpreting WBC counts.
• WBC counts between 11 and 14.5 × 10^9 WBCs/L may be considered normal in hospitalized patients, necessitating cautious interpretation.