Predictive Value of Routine Laboratory Tests for Early Death in Pediatric Hemophagocytic Lymphohistiocytosis Patients

Background: Hemophagocytic lymphohistiocytosis (HLH) is a severe systemic hyperinflammation with a high early death rate. The present study retrospectively reviewed the potential relationship between routine laboratory tests and early death in pediatric HLH patients. Methods: Sixty-four pediatric HLH patients with complete routine laboratory test results and patient information data were divided into Group D (patients who died within two months of hospitalisation) and Group S (patients who survived for more than two months or were ultimately discharged). Demographic characteristics and routine laboratory data were analysed using the Wilcoxon test, LASSO regression and logistic regression. Results: Most of the patients in Group D were under the age of two. Univariate analysis showed that low red blood cell (RBC), low haemoglobin (Hb), low albumin (ALB), low fibrinogen (FIB), prolonged partially activated prothrombin time (APTT), and high lactate dehydrogenase (LDH) were associated with early death in pediatric HLH patients. Among these routine laboratory tests, ALB had the highest area under the curve (AUC). LASSO regression and logistic regression showed that ALB correlated with early death in pediatric HLH patients. Conclusions: Our study highlights the importance of routine laboratory tests, especially ALB levels, in predicting early death in pediatric HLH patients. Under the age of 2, multi-organ or system involvement may increase the risk of early death.