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Title: Lymphocytopenia as a Predictor of Mortality in Patients with ICU-Acquired Pneumonia
Author: Ceccato, Adrian
Panagiotarakou, Meropi
Ranzani, Otavio T.
Martín Fernández, Marta
Almansa Mora, Raquel
Gabarrús, Albert
Bueno, Leticia
Cillóniz, Catia
Liapikou, Adamantia
Ferrer, Miquel
Bermejo Martín, Jesús
Torres Martí, Antoni
Keywords: Pneumònia adquirida a la comunitat
Community-acquired pneumonia
Issue Date: 1-Jan-2019
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.
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It is part of: Journal of Clinical Medicine, 2019, vol. 8, num. 6, 843
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ISSN: 2077-0383
Appears in Collections:Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Medicina)

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