Predictive value of admission biomarkers for mortality and rehospitalization in hypertensive crisis

AIM: To identify predictors of all-cause mortality and 6-month rehospitalisation in patients with hypertensive crisis, focusing on inflammatory indices, metabolic markers measured at admission, and antihypertensive treatment profiles. METHODS: This prospective observational study included 210 adult patients with hypertensive crisis. Demographic, clinical, and therapeutic data were collected, including data on comorbidities, antihypertensive drug use, and treatment adherence. Laboratory parameters obtained at admission included neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), homocysteine, and uric acid. Patients were followed for 12 months. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to identify independent predictors. RESULTS: Mortality occurred in 10.9% of patients, and 27.1% were rehospitalised within 6 months. Deceased patients exhibited significantly higher levels of PLR (p=0.0329), SII (p=0.0355), homocysteine (p=0.0488), and uric acid (p=0.021). In multivariate analysis, homocysteine (OR=3.55; p