RT info:eu-repo/semantics/doctoralThesis
T1 Valor pronóstico de la linfopenia en la mortalidad a los 2 años en el shock séptico
A1 Rico Feijoo, Jesús
A2 Universidad de Valladolid. Escuela de Doctorado
K1 Critical care medicine
K1 Sepsis
K1 Sepsis
K1 Lymphocytes
K1 Linfocitos
K1 Mortality
K1 Mortalidad
K1 3109.10 Cirugía
AB Background and Objective:The diagnosis of infection, especially in the context of septic shock, has traditionally relied on leukocyte counts and protein biomarkers. Despite advancements, mortality rates persistently range from 20% to 50%, increasing in the long term. The sepsis definition excludes leukocyte counts, and short-term mortality has been associated with lymphopenia. However, the existence of immunosuppression and increased long-term sepsis-related mortality remains unproven. This study aims to establish a correlation between the onset of lymphopenia and its non-recovery during septic shock with 2-year mortality.Patients and Methods:A cohort of 332 elderly patients diagnosed with septic shock underwent examination. Mortality at 28 days and 2 years was analyzed based on leukocyte, neutrophil, and lymphocyte counts, as well as the ability to recover from lymphopenia (LRec).Results:Lymphopenia was observed in 74.1% of patients, persisting in 66.3% during ICU stay. Mortality rates were 31.0% and 50.3% at 28 days and 2 years, respectively. A leukocyte count < 12,000 µL-1 predicted early mortality (OR 2.96), while delayed LRec predicted late mortality (OR 3.98). Long-term mortality was associated with LRec (HR 1.69).Conclusions:In elderly patients with septic shock, the absence of leukocytosis and neutrophilia is linked to 28-day mortality, and LRec is associated with 2-year mortality, suggesting two distinct phenotypes of post-septic shock behavior.
YR 2024
FD 2024
LK https://uvadoc.uva.es/handle/10324/66870
UL https://uvadoc.uva.es/handle/10324/66870
LA spa
NO Escuela de Doctorado
DS UVaDOC
RD 24-nov-2024