Persistent Lymphopenia after Diagnosis of Sepsis Predicts Mortality
Abstract
ABSTRACT Objective: The objective of this study was to determine whether persistent lymphopenia on the fourth day following the diagnosis of sepsis predicts mortality. Methods: This was a single-center, retrospective cohort study of 335 adult patients with bacteremia and sepsis admitted to a large university-affiliated tertiary care hospital between January 1, 2010, and July 31, 2012. All complete blood cell count profiles during the first 4 days following the diagnosis of sepsis were recorded. The primary outcome was 28-day mortality. Secondary outcomes included development of secondary infections, 1-year mortality, and hospital and intensive care unit lengths of stay. Results: Seventy-six patients (22.7%) died within 28 days. Lymphopenia was present in 28-day survivors (median, 0.7 × 103 cells/&mgr;L; interquartile range [IQR], 0.4–1.1 × 103 cells/&mgr;L) and nonsurvivors (median, 0.6 × 103 cells/&mgr;L; IQR, 0.4–1.1 × 103 cells/&mgr;L) at the onset of sepsis and was not significantly different between the groups (P = 0.35). By day 4, the median absolute lymphocyte count was significantly higher in survivors compared with nonsurvivors (1.1 × 103 cells/&mgr;L [IQR, 0.7–1.5 × 103 cells/&mgr;L] vs. 0.7 × 103 cells/&mgr;L [IQR, 0.5–1.0 × 103 cells/&mgr;L]; P < 0.0001). Using logistic regression to account for potentially confounding factors (including age, Acute Physiology and Chronic Health Evaluation II score, comorbidities, surgical procedure during the study period, and…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 335 participants or records.
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