Evidence map›Paper›PMID 41711242›Full record

ArticleESC heart failure2026

Discharge neutrophily-to-lymphocyte ratio and its trajectory as predictors of 30-day outcomes in acute heart failure.

Gil Marcus, Shiri L Maymon, Eran Kalmanovich, Gil Moravsky, Ido Minha, Avishay Grupper, Anat Milman, Shmuel Fuchs, Sa'ar Minha

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In one paragraph

Article in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Gil MarcusDepartment of Cardiology, Shamir Medical Center, Be'er Ya'akov 70300, Israel.
Shiri L MaymonGray Faculty of Medical and Health Sciences, Tel-Aviv University, P.O. Box 39040, Tel-Aviv 6997801, Israel.
Eran KalmanovichDepartment of Cardiology, Shamir Medical Center, Be'er Ya'akov 70300, Israel.
Gil MoravskyDepartment of Cardiology, Shamir Medical Center, Be'er Ya'akov 70300, Israel.
Ido MinhaThe Rachel and Selim Benin School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel.
Avishay GrupperDepartment of Cardiology, Shamir Medical Center, Be'er Ya'akov 70300, Israel.ORCID 0000-0001-8710-650X
Anat MilmanDepartment of Cardiology, Shamir Medical Center, Be'er Ya'akov 70300, Israel.ORCID 0000-0002-8551-4101
Shmuel FuchsDepartment of Cardiology, Shamir Medical Center, Be'er Ya'akov 70300, Israel.
Sa'ar MinhaDepartment of Cardiology, Shamir Medical Center, Be'er Ya'akov 70300, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo evaluate whether discharge neutrophil-to-lymphocyte ratio (NLR) and its in-hospital trajectory predict 30-day outcomes after acute decompensated heart failure (ADHF) hospitalization, and to compare discharge NLR with admission NLR and with serial NLR measurement.

methodsRetrospective cohort of 6784 ADHF discharges (2007-17; median age 78 [interquartile range: 69-85] years; 48.8% women). Patients were classified by discharge NLR (<5 vs ≥5) and by NLR trajectory (low→low, low→high, high→low, high→high). Primary endpoints were 30-day all-cause readmission and 30-day all-cause mortality. Multivariable Cox models adjusted for age, sex, anaemia, chronic kidney disease, diabetes, ischaemic heart disease, atrial fibrillation, peripheral vascular disease, and COPD. Discrimination was assessed using areas under the curve (AUCs) from adjusted logistic models.

resultsHigh discharge NLR (≥5) was present in 2258/6784 (33.3%). Event rates were higher with high vs low discharge NLR for readmission (25.5% vs 19.7%, P < .001) and mortality (7.8% vs 2.8%, P < .001). High discharge NLR was independently associated with readmission (hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.05-1.40, P = .007) and mortality (HR 1.92, 95% CI 1.46-2.53, P < .001). Trajectory further stratified risk: high→high had the greatest risk (readmission HR 1.42, 95% CI 1.25-1.62, P < .001; mortality HR 3.42, 95% CI 2.53-4.62, P < .001); low→high was also high-risk (readmission HR 1.46, 95% CI 1.20-1.77, P < .001; mortality HR 3.05, 95% CI 2.00-4.65, P < .001). High→low showed reduced but residual risk vs low→low (readmission HR 1.07, 95% CI .93-1.23, P = .321; mortality HR 1.52, 95% CI 1.06-2.16, P = .021). Discharge NLR outperformed admission NLR (mortality AUC 0.731 vs 0.705; readmission AUC 0.573 vs 0.564). Serial NLR added minimal discrimination beyond discharge NLR alone (mortality AUC 0.736 vs 0.734; readmission AUC 0.571 for both).

conclusionsDischarge NLR is an independently prognostic, routinely available biomarker for 30-day readmission and mortality after ADHF. Persistently elevated or rising NLR identifies patients at the highest short-term risk, while normalization attenuates but does not eliminate risk. A single discharge measurement performs comparably to serial assessment, supporting practical integration of discharge NLR into risk-stratified follow-up, including in resource-limited settings.

Indexed as

Heart FailureLymphocytesNeutrophilsPatient DischargeAcute DiseaseAgedAged, 80 and overFemaleFollow-Up StudiesHumansMalePatient ReadmissionPrognosisRetrospective StudiesRisk FactorsSurvival Rate30-day mortality30-day readmissionAcute decompensated heart failureDischarge biomarkersNeutrophil-to-lymphocyte ratio

Identifiers

PMID41711242
PMCPMC13122620

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.