RT info:eu-repo/semantics/article
T1 Early natural killer cell counts in blood predict mortality in severe sepsis
A1 Andaluz Ojeda, David
A1 Iglesias, Verónica
A1 Bobillo, Felipe
A1 Almansa Mora, Raquel
A1 Rico, Lucía
A1 Gandía Martínez, Francisco
A1 Loma, Ana María
A1 Nieto, Concepción
A1 Diego, Rosa
A1 Ramos, Epifanio
A1 Nocito Colón, Mercedes
A1 Resino, Salvador
A1 Eiros Bouza, José María
A1 Tamayo Gómez, Eduardo
A1 Ortiz de Lejarazu Leonardo, Raúl
A1 Bermejo Martín, Jesús Francisco
K1 Septicemia - Mortalidad
AB In an attempt to evaluate the quantitative changes in the status of immunocompetence in severe sepsis over time and its potential influence on clinical outcome, we monitored the evolution of immunoglobulins (Igs) (IgG, IgA and IgM), complement factors (C3 and C4) and lymphocyte subsets (CD4+ T cells, CD8+ T cells, B cells (CD19+) and natural killer (NK) cells (CD3-CD16+CD56+)) in the blood of 50 patients with severe sepsis or septic shock at day 1, day 3 and day 10 following admission to the ICU.Twenty-one patients died, ten of whom died within the 72 hours following admission to the ICU. The most frequent cause of death (n = 12) was multiorgan dysfunction syndrome. At day 1, survivors showed significantly higher levels of IgG and C4 than those who ultimately died. On the contrary, NK cell levels were significantly higher in the patients who died. Survivors exhibited a progressive increase from day 1 to day 10 on most of the immunological parameters evaluated (IgG, IgA, IgM, C3, CD4+, CD8+ T cells and NK cells). Multivariate Cox regression analysis, including age, sex, APACHE II score, severe sepsis or septic shock status and each one of the immunological parameters showed that NK cell counts at day 1 were independently associated with increased risk of death at 28 days (hazard ratio = 3.34, 95% CI = 1.29 to 8.64; P = 0.013). Analysis of survival curves provided evidence that levels of NK cells at day 1 (> 83 cells/mm3) were associated with early mortality.Our results demonstrate the prognostic role of NK cells in severe sepsis and provide evidence for a direct association of early counts of these cells in blood with mortality.
PB BioMed Central
SN 1364-8535
YR 2011
FD 2011
LK http://uvadoc.uva.es/handle/10324/13823
UL http://uvadoc.uva.es/handle/10324/13823
LA eng
NO Critical Care, 2011, 15(5):R243
NO Producción Científica
DS UVaDOC
RD 22-nov-2024