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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 Mortalitat Community-acquired pneumonia Mortality |
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. |
Note: | Reproducció del document publicat a: https://doi.org/10.3390/jcm8060843 |
It is part of: | Journal of Clinical Medicine, 2019, vol. 8, num. 6, 843 |
URI: | http://hdl.handle.net/2445/136397 |
Related resource: | https://doi.org/10.3390/jcm8060843 |
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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