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Leveraging Hematologic Single-Cell Measurements for Patient Triage and Outcome Prediction
Ya-Lin Chen1,2, Fabienne Lucas1, Brody H Foy1
1Department of Laboratory Medicine & Pathology, University of Washington, Seattle, WA, United States.
Insights
Cell population data (CPD) from complete blood counts (CBC) offer valuable prognostic insights beyond standard markers. These additional markers improve predictions for patient mortality and hospital admissions.
Area of Science:
- Hematology
- Clinical Pathology
- Medical Informatics
Background:
- The complete blood count (CBC) is a cornerstone diagnostic tool in medicine.
- Modern hematology analyzers provide extensive cell population data (CPD) beyond standard CBC markers.
- The prognostic utility of CPD in general patient populations remains underexplored.
Purpose of the Study:
- To determine if cell population data (CPD) markers offer prognostic value beyond traditional complete blood count (CBC) markers.
- To assess the association of CPD markers with general patient outcomes.
- To evaluate the impact of incorporating CPD markers into predictive models.
Main Methods:
- Retrospective analysis of CBC and CPD markers from over 10,000 patients.
- Univariate and multivariate analyses of marker associations with inpatient admission, mortality, and length-of-stay.
- Machine learning models were developed using CBC and CPD markers for outcome prediction.
Main Results:
- Numerous CPD markers demonstrated significant associations with mortality, length-of-stay, and emergency department admissions.
- CPD markers maintained prognostic significance across diverse patient demographics and medical specialties, even after adjusting for CBC markers.
- Machine learning models incorporating CPD markers showed improved predictive performance (AUC 0.79 for mortality, 0.81 for admission).
- Two distinct CPD phenotypes were identified: inflammatory (linked to admission) and dysregulatory (linked to mortality).
Conclusions:
- Routinely available cell population data (CPD) can significantly enhance the prognostic capabilities of the complete blood count (CBC).
- CPD markers provide valuable information for evaluating general patient cohorts, complementing standard hematological assessments.
- The findings support the integration of CPD analysis into routine clinical practice for improved patient risk stratification.
Background:
The complete blood count (CBC) is widely used across nearly all areas of medicine. While standard CBC markers reflect basic summaries of the blood cells, modern hematology analyzers generate many additional markers from the underlying data distributions-collectively referred to as cell population data (CPD). While CPD markers have been studied in targeted clinical settings, their value for general prognostic tasks has not yet been established. In this brief report, we assess whether CPD markers can provide additional prognostic information beyond CBC markers in general patient cohorts.
Methods:
We retrospectively analyzed CBC and CPD markers from over 10 000 patients at a large academic medical center between March 14, 2024, and October 23, 2024. Marker associations with general outcomes (inpatient admission from the emergency department, mortality, and length-of-stay) were analyzed in both univariate and multivariate models. Outcomes were also predicted using CBC- and CPD-based machine learning models.
Results:
Many CPD markers were strongly associated with patient mortality, length-of-stay, and inpatient admission from the emergency department. CPD markers showed consistent outcome associations after stratification by patient demographics and medical specialties, and many retained statistical significance after controlling for commonly used CBC markers. In machine learning modelling, inclusion of CPD markers enhanced predictive performance for mortality [area under the curve (AUC): 0.79] and inpatient admission (AUC: 0.81). Analysis of CPD markers revealed 2 phenotypes: an inflammatory phenotype associated with inpatient admission and a dysregulatory phenotype associated with mortality.
Conclusions:
These results highlight how routinely collected CPD markers may enhance the use of the CBC for evaluation of general patient cohorts.
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