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淋巴细胞减少与脓毒症患者短期预后的关联;简要报告

Association of Lymphopenia with Short Term Outcomes of Sepsis Patients; a Brief Report.

作者信息

Sheikh Motahar Vahedi Hojat, Bagheri Aida, Jahanshir Amirhosein, Seyedhosseini Javad, Vahidi Elnaz

机构信息

Prehospital Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Department of Emergency Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Acad Emerg Med. 2019 Jan 20;7(1):e14. eCollection 2019 Winter.

Abstract

INTRODUCTION

Studies have claimed that low lymphocyte count is independently correlated with 28-day survival of sepsis patients. Therefore, this study aimed to evaluate the value of lymphopenia in predicting the short-term outcome of sepsis patients.

METHODS

This cross-sectional study was performed on sepsis patients referred to the emergency department during an 8-month period and relationship of lymphopenia with 28-day mortality and probability of septic shock and readmission due to sepsis was assessed.

RESULTS

124 cases with the mean age of 66.12 15.82 (21-90) years were studied (54.8% male). 81 (65.3%) cases had lymphopenia (59.3% male). Lymphopenic patients had a significantly higher mean age (p = 0.003), higher need for ICU admission (p < 0.001), higher prevalence of 28-day septic shock (p < 0.001), higher 28-day mortality (p < 0.001), higher probability of readmission due to sepsis (p = 0.048), and higher SOFA score (p < 0.001). During 28 days of follow up, 57 (46%) patients were expired. They had a higher prevalence of septic shock (p < 0.001) and higher SOFA score (p < 0.001). Multivariate analysis showed that septic shock (OR=364.6; 95% CI: 26.3 to 5051.7; p = 0.001) and lymphopenia (OR=19.2; 95% CI: 1.7 to 211.3; p = 0.016) were the independent predictors of 28-day mortality.

CONCLUSIONS

Based on the findings, lymphopenia was independently associated with higher 28-day mortality and lymphopenic patients were older than the control group and had a significantly higher need for ICU admission, higher probability of 28-day septic shock and readmission due to sepsis, and higher SOFA score.

摘要

引言

研究表明,淋巴细胞计数低与脓毒症患者的28天生存率独立相关。因此,本研究旨在评估淋巴细胞减少症在预测脓毒症患者短期预后中的价值。

方法

本横断面研究对在8个月期间转诊至急诊科的脓毒症患者进行,评估淋巴细胞减少症与28天死亡率、感染性休克概率以及因脓毒症再次入院的关系。

结果

研究了124例患者,平均年龄为66.12±15.82(21 - 90)岁(男性占54.8%)。81例(65.3%)患者存在淋巴细胞减少症(男性占59.3%)。淋巴细胞减少症患者的平均年龄显著更高(p = 0.003),入住重症监护病房的需求更高(p < 0.001),28天感染性休克的患病率更高(p < 0.001),28天死亡率更高(p < 0.001),因脓毒症再次入院的概率更高(p = 0.048),序贯器官衰竭评估(SOFA)评分更高(p < 0.001)。在28天的随访期间,57例(46%)患者死亡。他们感染性休克的患病率更高(p < 0.001),SOFA评分更高(p < 0.001)。多因素分析表明,感染性休克(比值比[OR]=364.6;95%置信区间[CI]:26.3至5051.7;p = 0.001)和淋巴细胞减少症(OR=19.2;95% CI:1.7至211.3;p = 0.016)是28天死亡率的独立预测因素。

结论

基于这些发现,淋巴细胞减少症与28天死亡率升高独立相关,淋巴细胞减少症患者比对照组年龄更大,入住重症监护病房的需求显著更高,28天感染性休克和因脓毒症再次入院的概率更高,SOFA评分更高。

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