RT info:eu-repo/semantics/article
T1 Impact of Lymphocyte and Neutrophil Counts on Mortality Risk in Severe Community-Acquired Pneumonia with or without Septic Shock
A1 Güell, Estel
A1 Martín Fernández, Marta
A1 De la Torre, Mari C.
A1 Palomera, Elisabet
A1 Serra, Mateu
A1 Martinez, Rafael
A1 Solsona, Manel
A1 Miró, Gloria
A1 Vallès, Jordi
A1 Fernández, Samuel
A1 Cortés, Edgar
A1 Ferrer, Vanessa
A1 Morales, Marc
A1 Yébenes, Juan C.
A1 Almirall, Jordi
A1 Bermejo-Martin, Jesús F.
AB Background: Community-acquired pneumonia (CAP) is a frequent cause of death worldwide. As recently described, CAP shows different biological endotypes. Improving characterization of these endotypes is needed to optimize individualized treatment of this disease. The potential value of the leukogram to assist prognosis in severe CAP has not been previously addressed.Methods: A cohort of 710 patients with CAP admitted to the intensive care units (ICUs) at Hospital of Mataró and Parc Taulí Hospital of Sabadell was retrospectively analyzed. Patients were split in those with septic shock (n = 304) and those with no septic shock (n = 406). A single blood sample was drawn from all the patients at the time of admission to the emergency room. ICU mortality was the main outcome.Results: Multivariate analysis demonstrated that lymphopenia <675 cells/mm3 or <501 cells/mm3 translated into 2.32- and 3.76-fold risk of mortality in patients with or without septic shock, respectively. In turn, neutrophil counts were associated with prognosis just in the group of patients with septic shock, where neutrophils <8850 cells/mm3 translated into 3.6-fold risk of mortality.Conclusion: lymphopenia is a preserved risk factor for mortality across the different clinical presentations of severe CAP (sCAP), while failing to expand circulating neutrophils counts beyond the upper limit of normality represents an incremental immunological failure observed just in those patients with the most severe form of CAP, septic shock.
YR 2019
FD 2019
LK https://uvadoc.uva.es/handle/10324/64646
UL https://uvadoc.uva.es/handle/10324/64646
LA eng
NO J Clin Med. 2019 May 27;8(5):754
NO Producción Científica
DS UVaDOC
RD 19-nov-2024