Abstract
Background
The leukocyte glucose index (LGI), derived from leukocyte count and admission glucose, may reflect inflammatory and metabolic stress in acute pulmonary embolism (APE). We examined its association with adverse outcomes and compared its discrimination with admission glucose and the simplified Pulmonary Embolism Severity Index (sPESI).Methods
This retrospective study included 205 patients with computed tomography pulmonary angiography-confirmed APE. Endpoints were in-hospital mortality and composite adverse outcomes. Multivariable logistic regression assessed associations. Diabetes mellitus (DM) was defined as documented DM, glycated hemoglobin (HbA1c) ≥6.5%, or admission glucose ≥200 mg/dL. Strict DM required documented DM or HbA1c ≥6.5%. LGI × DM interactions were tested. Paired DeLong tests compared areas under the receiver operating characteristic curve (AUCs). Internal validation used 2000 bootstrap resamples. Sensitivity analysis evaluated in-hospital death or admission systolic blood pressure Results
LGI was independently associated with mortality (adjusted odds ratio [OR] 1.64, 95% confidence interval [CI] 1.25-2.16, P Conclusions
Admission LGI was independently associated with adverse outcomes, showed better discrimination than admission glucose, and improved sPESI discrimination. External validation is required.