{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:46:58Z","timestamp":1773006418413,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>As a well\u2010established inflammatory biomarker, leukocyte count is associated with higher mortality in acute pulmonary embolism (PE). We aimed to confirm the prognostic utility of leukocyte count and its integration with simplified Pulmonary Embolism Severity Index (sPESI) for predicting all\u2010cause hospital mortality in acute PE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data derived from a national, multicentre and prospective registry including patients with acute PE were analysed to develop and validate an in\u2010hospital mortality prediction model incorporating leukocyte count and sPESI. Mendelian Randomisation (MR) was performed to assess the relationship between leukocyte count and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 7312 PE patients were stratified into three groups based on admission leukocyte count: &lt;\u20094\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009301, 4.1%), (4\u201310)\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095074, 69.4%) and &gt;\u200910\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091937, 26.5%). Patients with leukocytosis exhibited a higher prevalence of anaemia, thrombocytopenia, hypoxemia, cardiac and renal injury, as well as haemodynamic instability. The in\u2010hospital all\u2010cause mortality was 3.0%, 2.3% and 6.4% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) across the three groups, respectively. The area under the curve (AUC) of sPESI was 0.719 (95% CI 0.681\u20130.756,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), increasing to 0.738 (95% CI 0.701\u20130.775,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) when combined with leukocyte count groups. The prognostic value of leukocyte count and its combination with sPESI was validated in a cohort with 7660 PE patients. MR analysis demonstrated that elevated leukocyte counts increased mortality risk (OR\u2009=\u20091.11, 95% CI 1.00\u20131.24,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Admission leukocyte count enhances the prognostic accuracy of sPESI for in\u2010hospital all\u2010cause mortality in PE. Leukocyte count could serve as a potential biomarker for identifying PE patients at increased mortality risk.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/resp70171-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/resp.70171","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T01:40:18Z","timestamp":1765417218000},"page":"305-315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Leukocyte Count as an In\u2010Hospital Prognostic Indicator in Acute Pulmonary Embolism: Evidence From a Registry Study and Genetic Analyses"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3247-5847","authenticated-orcid":false,"given":"Shuai","family":"Zhang","sequence":"first","affiliation":[{"name":"National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine Center of Respiratory Medicine, China\u2013Japan Friendship Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haobo","family":"Li","sequence":"additional","affiliation":[{"name":"National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine Center of Respiratory Medicine, China\u2013Japan Friendship Hospital  Beijing China"},{"name":"China\u2013Japan Friendship Hospital Chinese Academy of Medical Sciences, Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Beijing Anzhen Hospital Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaomao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Beijing Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingqun","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, East Hospital Tongji University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanhua","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qun","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, West China Hospital, West China School of Medicine Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine The First Affiliated Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyun","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine First Hospital of Shanxi Medical University  Taiyuan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhihong","family":"Liu","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, Chinese Academy of Medical Science National Center for Cardiovascular Diseases  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yimin","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine The First Affiliated Hospital of Henan University of Science and Technology  Luoyang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine The Second Hospital of Jilin University  Changchun China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juhong","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine 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and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine Center of Respiratory Medicine, China\u2013Japan Friendship Hospital  Beijing China"},{"name":"Data and Project Management Unit, Institute of Clinical Medical Sciences China\u2013Japan Friendship Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhu","family":"Zhang","sequence":"additional","affiliation":[{"name":"National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine Center of Respiratory Medicine, China\u2013Japan Friendship Hospital  Beijing 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