Dataset Information

Lymphocytopenia as a Predictor of Mortality in Patients with ICU-Acquired Pneumonia.

ABSTRACT:

Background

Intensive care unit-acquired pneumonia (ICU-AP) is a severe complication in patients admitted to the ICU. Lymphocytopenia is a marker of poor prognosis in patients with community-acquired pneumonia, but its impact on ICU-AP prognosis is unknown. We aimed to evaluate whether lymphocytopenia is an independent risk factor for mortality in non-immunocompromised patients with ICU-AP.

Methods

Prospective observational cohort study of patients from six ICUs of an 800-bed tertiary teaching hospital (2005 to 2016).

Results

Of the 473 patients included, 277 (59%) had ventilator-associated pneumonia (VAP). Receiver operating characteristic (ROC) analysis of the lymphocyte counts at diagnosis showed that 595 cells/mm³ was the best cut-off for discriminating two groups of patients at risk: lymphocytopenic group (lymphocyte count <595 cells/mm³, 141 patients (30%)) and non-lymphocytopenic group (lymphocyte count ?595 cells/mm³, 332 patients (70%)). Patients with lymphocytopenia presented more comorbidities and a higher sequential organ failure assessment (SOFA) score at the moment of pneumonia diagnosis. Also, 28-day mortality and 90-day mortality were higher in patients with lymphocytopenia (28-day: 38 (27%) versus 59 (18%), 90-day: 74 (53%) versus 111 (34%)). In the multivariable model, <595 cells/mm³ resulted to be an independent predictor for 90-day mortality (Hazard Ratio 1.41; 95% Confidence Interval 1.02 to 1.94).

Conclusion

Lymphocytopenia is an independent predictor of 90-day mortality in non-immunocompromised patients with ICU-AP.

SUBMITTER: Ceccato A

PROVIDER: S-EPMC6617552 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Publications

Lymphocytopenia as a Predictor of Mortality in Patients with ICU-Acquired Pneumonia.

Ceccato Adrian A Panagiotarakou Meropi M Ranzani Otavio T OT Martin-Fernandez Marta M Almansa-Mora Raquel R Gabarrus Albert A Bueno Leticia L Cilloniz Catia C Liapikou Adamantia A Ferrer Miquel M Bermejo-Martin Jesus F JF Torres Antoni A

Journal of clinical medicine 20190613 6

<h4>Background</h4>Intensive care unit-acquired pneumonia (ICU-AP) is a severe complication in patients admitted to the ICU. Lymphocytopenia is a marker of poor prognosis in patients with community-acquired pneumonia, but its impact on ICU-AP prognosis is unknown. We aimed to evaluate whether lymphocytopenia is an independent risk factor for mortality in non-immunocompromised patients with ICU-AP.<h4>Methods</h4>Prospective observational cohort study of patients from six ICUs of an 800-bed terti ...[more]

PMID: 31200458

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Dataset Information

Lymphocytopenia as a Predictor of Mortality in Patients with ICU-Acquired Pneumonia.

Background

Methods

Results

Conclusion

Publications

Lymphocytopenia as a Predictor of Mortality in Patients with ICU-Acquired Pneumonia.

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