Association between CDSS score and 30-day mortality in nonAPL acute leukemia patients with intracranial hemorrhage: a
Jia Yuan Zhang1,2, Zhang-Song Yan1,2, Da Peng Li1,2
1Department of Emergency, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China.
Insights
The Chinese DIC Scoring System (CDSS) score predicts 30-day mortality in acute leukemia patients with intracranial hemorrhage. Higher CDSS scores, especially ≥6, indicate significantly increased mortality risk.
Area of Science:
- Hematology
- Neurology
- Critical Care Medicine
Background:
- Acute leukemia patients face high mortality, especially when complicated by intracranial hemorrhage (ICH).
- Predictive tools are crucial for managing these high-risk patients.
- The Chinese DIC Scoring System (CDSS) is used for disseminated intravascular coagulation, but its prognostic value in ICH with acute leukemia is under-explored.
Purpose of the Study:
- To investigate the correlation between the CDSS score and 30-day mortality in patients with non-acute promyelocytic leukemia (APL) acute leukemia and ICH.
- To assess the prognostic significance of CDSS scores in this specific patient cohort.
Main Methods:
- A cohort study involving 82 patients with non-APL acute leukemia and ICH.
- CDSS scores were calculated for all patients.
- Multivariable Cox regression analysis was employed to determine the association between CDSS score and 30-day mortality.
- Stratified analyses were performed based on clinical variables.
Main Results:
- The overall 30-day mortality rate was 61.0%.
- Patients with CDSS scores ≥6 had a significantly higher mortality rate (87%) compared to those with scores <6 (50.8%) (p=0.002).
- Each one-point increase in CDSS score was associated with a 28% increase in 30-day mortality (HR=1.28). CDSS scores ≥6 showed a 124% increase in mortality risk (HR=2.24).
Conclusions:
- The CDSS score is a significant predictor of 30-day mortality in patients with non-APL acute leukemia and ICH.
- A higher CDSS score, particularly ≥6, is strongly associated with increased mortality in this population.
Objectives:
The aim of this study was to investigate the correlation between CDSS (Chinese DIC Scoring System) score and 30-day mortality in patients with intracranial hemorrhage (ICH) with nonacute promyelocytic leukemia (APL) acute leukemia.
Methods:
This cohort study enrolled patients with non-APL acute leukemia complicated by ICH. The CDSS score was assessed in this patient population. Multivariable Cox regression was used to analyze the association between CDSS score and 30-day mortality. Additionally, interaction and stratified analyses were conducted based on variables such as age, sex, white blood cell count, platelet count, and albumin levels.
Results:
In a study involving 82 patients diagnosed as non-APL acute leukemia with ICH, the overall 30-day mortality rate was 61.0%, with 50 out of the 82 patients succumbing to the condition. Among those with CDSS scores ≥6, the mortality rate was 87% (20 out of 23), which was higher than the 50.8% mortality rate of the CDSS scores < 6 group (30 out of 59) (p = 0.002). In multivariate regression models, a 28% increase in 30-day mortality was linked to a one-point increase in CDSS score(HR = 1.28, 95% CI 1.06-1.56). Furthermore, it was associated with a 124% increase in 30-day mortality in CDSS scores ≥ 6 compared with that in the CDSS scores < 6 (HR = 2.24, 95% CI 1.1-4.56). Interaction analysis revealed no significant interactive effect on the relationship between CDSS score and 30-day mortality.
Conclusions:
The CDSS score was linked to a higher 30-day mortality rate, particularly in patients with CDSS scores ≥ 6.
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