Association between CDSS score and 30-day mortality in nonAPL acute leukemia patients with intracranial hemorrhage: a cohort study

Abstract

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.

Keywords: Acute leukemia (AL); Chinese DIC scoring system (CDSS); disseminated intravascular coagulation (DIC); intracranial hemorrhage; non-acute promyelocytic leukemia (non-APL).