Total, differential white blood cell counts predict mortality in adults

Total and differential counts of white blood cell (WBC)—neutrophils, monocytes, and neutrophil/lymphocyte ratio—appear to be positively associated with the risk of mortality from all cause as well as from cardiovascular and cerebrovascular diseases, cancer, and respiratory diseases among Taiwanese adults, a study has found.

The analysis included 436,750 Taiwanese adults. Cox proportional hazards model was used to examine the WBC counts in relation with mortality outcomes separately for men and women. Variables such as age, smoking, and other lifestyle factors were included as potential confounders. Subgroup analyses were also conducted to explore potential effect modification.

Elevated WBC count was strongly associated with increased mortality risk. Men and women in the highest vs lowest decile of total WBC had 42-percent and 54-percent higher risk of all-cause mortality, respectively (hazard ratio [HR], 1.42, 95 percent confidence interval [CI], 1.33–1.53 and HR, 1.54, 95 percent CI, 1.42–1.68). Similar risk estimates were observed for neutrophils, monocytes, and neutrophil/lymphocyte ratio.

Furthermore, the highest deciles of neutrophils, monocytes, and NL ratio were predictive of increased risk of cardiovascular/cerebrovascular, cancer, and respiratory mortality.

The association between elevated WBC count and high all-cause mortality risk was observed among men and women aged <60 years, nonsmokers, nondiabetics, and nonhypertensives.