Study identifies persistent lymphopenia as Key Predictor of In-Hospital Mortality in Immunocompromised CKD Patients

Results: The findings indicate that ventilator use, vasoactive drug administration, elevated lactate dehydrogenase (LDH), total bilirubin (TBIL) levels, and persistent lymphopenia(PL) are effective predictors of in-hospital mortality in immunocompromised patients with severe infections. These variables were subsequently incorporated to construct a robust prognostic model.

Our model demonstrated excellent discriminative ability (AUC = 0.959, 95% CI, 0.924–0.994), significantly outperforming the Sequential Organ Failure Assessment (SOFA) score (AUC = 0.878, 95% CI, 0.825–0.930) and quick Pitt Bacteremia Score (qPBS) (AUC = 0.897, 95% CI, 0.846–0.947). Calibration curve analysis and the Hosmer-Lemeshow (HL) test corroborate the concordance of our model with empirical observations.

Furthermore, decision curve analysis (DCA) underscores the superior clinical utility of our predictive model when compared to the SOFA score and qPBS score. Most importantly, our results showed that PL is the most important predictor of in-hospital mortality in immunocompromised patients following severe infection. The findings highlight PL as the most significant predictor of in-hospital mortality in immunocompromised CKD patients. A clinical prediction model incorporating PL as a key variable exhibited robust performance in terms of diagnostic accuracy and clinical utility.

Reference:

Wang, Y., Zhou, Y., Huang, C. et al. Development of a prediction model for in-hospital mortality in immunocompromised chronic kidney diseases patients with severe infection. BMC Nephrol 26, 78 (2025). https://doi.org/10.1186/s12882-025-04002-9