Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Department of Respiratory Medicine, National Hospital Organization Higashinagoya National Hospital, Nagoya, Japan.
Sci Rep. 2022 Aug 26;12(1):14564. doi: 10.1038/s41598-022-18794-5.
The prognostic significance of absolute lymphocyte count (ALC) and absolute neutrophil count (ANC) remains unclear in patients with postoperative pneumonia (POP). The study objectives were to investigate the prognostic effects of ALC and ANC in POP patients, and to evaluate the time courses of ALC and ANC during hospitalization. This post-hoc analysis of a single-center prospective observational study evaluated consecutive POP patients, and comparatively analyzed community-acquired pneumonia (CAP) patients to highlight features of POP. In total, 228 POP patients and 1027 CAP patients were assessed. Severe lymphopenia (ALC < 500 cells/μL) at diagnosis was associated with worse 90-day survival in both types of pneumonia. In POP patients, neutrophilia (ANC > 7500 cells/μL) was associated with better survival, whereas CAP patients with neutrophilia tended to have a lower survival rate. Prolonged lymphopenia and delayed increase in neutrophils were characteristic time-course changes of non-survivors in POP. The time courses of ALC and ANC between survivors and non-survivors in POP trended differently from those in CAP. Our study showed that ALC and ANC at pneumonia diagnosis can serve as prognostic factors in POP patients. Differences in time-course changes of ALC and ANC between survivors and non-survivors may provide important information for future immunological research in pneumonia.
术后肺炎（POP）患者的绝对淋巴细胞计数（ALC）和绝对中性粒细胞计数（ANC）的预后意义尚不清楚。本研究旨在探讨 ALC 和 ANC 在 POP 患者中的预后作用，并评估住院期间 ALC 和 ANC 的时间变化。这项对单中心前瞻性观察研究的事后分析评估了连续的 POP 患者，并与社区获得性肺炎（CAP）患者进行了比较分析，以突出 POP 的特征。共评估了 228 例 POP 患者和 1027 例 CAP 患者。诊断时严重的淋巴细胞减少症（ALC<500 个细胞/μL）与两种类型肺炎的 90 天生存率降低相关。在 POP 患者中，中性粒细胞增多症（ANC>7500 个细胞/μL）与生存率提高相关，而 CAP 患者的中性粒细胞增多症往往生存率降低。持续性淋巴细胞减少症和中性粒细胞增加延迟是 POP 患者非幸存者的特征性时间变化。POP 患者中幸存者和非幸存者的 ALC 和 ANC 时间变化趋势与 CAP 不同。本研究表明，肺炎诊断时的 ALC 和 ANC 可作为 POP 患者的预后因素。幸存者和非幸存者之间的 ALC 和 ANC 时间变化的差异可能为未来肺炎的免疫学研究提供重要信息。
