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Relative lymphocyte count as an indicator of 3-year mortality in elderly people with severe COPD.

ABSTRACT: Prognostic stratification of elderly patients with chronic obstructive pulmonary disease (COPD) is difficult due to the wide inter-individual variability in the course of the disease. No marker can exactly stratify the evolution and natural history of COPD patients. Studies have shown that leukocyte count is associated with increased risk of mortality in COPD patients. The aim of this study was to evaluate the possible role of relative lymphocyte count as a risk marker for mortality in elderly patients with COPD.This is a3-year prospective study. A total of 218patients, mean age 75.2±7 years, with moderate to severe COPD and free from conditions affecting lymphocyte count were enrolled. The population was divided into two groups according to the relative lymphocyte count, with a cut-off of 20%. Eighty-five patients (39%) had a relative lymphocyte count ?20%. Three-year mortality rates from any cause in patients with relative lymphocyte count ? or?>?20% were 68 and 51%, respectively (p?= 0.0012). Survival curve analysis showed higher mortality in patients with relative lymphocyte count ?20% (p?= 0.0005). After adjustment for age and sex, the hazard ratio for mortality risk according to lymphocyte count was 1.79 (95% confidence interval [CI]: 1.26-2.57, p?= 0.0013), even in the analysis limited to the 171 patients without congestive heart failure (1.63; 95% CI: 1.03-2.58, p?=?0.038).Low relative lymphocyte count was associated with higher mortality in elderly patients with severe COPD.

SUBMITTER: Acanfora D

PROVIDER: S-EPMC6045885 | biostudies-other | 2018 Jul

REPOSITORIES: biostudies-other

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Relative lymphocyte count as an indicator of 3-year mortality in elderly people with severe COPD.

Acanfora Domenico D Scicchitano Pietro P Carone Mauro M Acanfora Chiara C Piscosquito Giuseppe G Maestri Roberto R Zito Annapaola A Dentamaro Ilaria I Longobardi Marialaura M Casucci Gerardo G Antonelli-Incalzi Raffaele R Ciccone Marco Matteo MM

BMC pulmonary medicine 20180713 1

<h4>Background</h4>Prognostic stratification of elderly patients with chronic obstructive pulmonary disease (COPD) is difficult due to the wide inter-individual variability in the course of the disease. No marker can exactly stratify the evolution and natural history of COPD patients. Studies have shown that leukocyte count is associated with increased risk of mortality in COPD patients. The aim of this study was to evaluate the possible role of relative lymphocyte count as a risk marker for mor ...[more]

PMID: 30005642

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Project description:BackgroundSocial vulnerability is related to the health of elderly people, but its measurement and relationship to frailty are controversial. The aims of the present study were to operationalize social vulnerability according to a deficit accumulation approach, to compare social vulnerability and frailty, and to study social vulnerability in relation to mortality.Methods and findingsThis is a secondary analysis of community-dwelling elderly people in two cohort studies, the Canadian Study of Health and Aging (CSHA, 1996/7-2001/2; N = 3707) and the National Population Health Survey (NPHS, 1994-2002; N = 2648). Social vulnerability index measures that used self-reported items (23 in NPHS, 40 in CSHA) were constructed. Each measure ranges from 0 (no vulnerability) to 1 (maximum vulnerability). The primary outcome measure was mortality over five (CHSA) or eight (NPHS) years. Associations with age, sex, and frailty (as measured by an analogously constructed frailty index) were also studied. All individuals had some degree of social vulnerability. Women had higher social vulnerability than men, and vulnerability increased with age. Frailty and social vulnerability were moderately correlated. Adjusting for age, sex, and frailty, each additional social 'deficit' was associated with an increased odds of mortality (5 years in CSHA, odds ratio = 1.05, 95% confidence interval: 1.02-1.07; 8 years in the NPHS, odds ratio = 1.08, 95% confidence interval: 1.03-1.14). We identified a meaningful survival gradient across quartiles of social vulnerability, and although women had better survival than men, survival for women with high social vulnerability was equivalent to that of men with low vulnerability.ConclusionsSocial vulnerability is reproducibly related to individual frailty/fitness, but distinct from it. Greater social vulnerability is associated with mortality in older adults. Further study on the measurement and operationalization of social vulnerability, and of its relationships to other important health outcomes, is warranted.

Dataset Information

Relative lymphocyte count as an indicator of 3-year mortality in elderly people with severe COPD.

Publications

Relative lymphocyte count as an indicator of 3-year mortality in elderly people with severe COPD.

Similar Datasets

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