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Peripheral monocytosis as a predictive factor for adverse outcome in the emergency department: Survey based on a register study

Monocytosis is associated with chronic infections such as tuberculosis or endocarditis as well as rheumatic and myeloproliferative disorders. Monocytes are also involved in the pathogenesis of atherosclerosis, coronary artery disease, and stroke. The value of monocytosis as a prognostic marker in di...

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Autores principales: Hensel, Mathias, Grädel, Lena, Kutz, Alexander, Haubitz, Sebastian, Huber, Andreas, Mueller, Beat, Schuetz, Philipp, Hügle, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5515748/
https://www.ncbi.nlm.nih.gov/pubmed/28700476
http://dx.doi.org/10.1097/MD.0000000000007404
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author Hensel, Mathias
Grädel, Lena
Kutz, Alexander
Haubitz, Sebastian
Huber, Andreas
Mueller, Beat
Schuetz, Philipp
Hügle, Thomas
author_facet Hensel, Mathias
Grädel, Lena
Kutz, Alexander
Haubitz, Sebastian
Huber, Andreas
Mueller, Beat
Schuetz, Philipp
Hügle, Thomas
author_sort Hensel, Mathias
collection PubMed
description Monocytosis is associated with chronic infections such as tuberculosis or endocarditis as well as rheumatic and myeloproliferative disorders. Monocytes are also involved in the pathogenesis of atherosclerosis, coronary artery disease, and stroke. The value of monocytosis as a prognostic marker in different diagnostic groups in the emergency setting, however, has not been investigated so far. The aim of the article is to study monocytosis as an outcome factor in the emergency setting. In a Swiss register study, we analyzed monocyte counts in 4238 patients aged >18 years who were admitted to the emergency department of a regional tertiary care hospital. Monocytosis was defined as 0.8×10(9) cells/L. Diagnoses were grouped into infection, cardiovascular, neurological, metabolic, gastrointestinal, pulmonary, or other. Thirty-day mortality was defined as the primary endpoint A total of 1217 patients with monocytosis were identified. Patients with monocytosis at admission suffered more frequently from respiratory symptoms (17.7% vs 8.9%, P <.001) and infection as the final diagnosis (20.8% vs 10.3%, P <.001) while neurological diagnoses were significantly lower in the monocytosis group (15.3% vs 30.9%, P <.001). Patients with monocytosis suffered from more comorbidities such as congestive heart failure, chronic obstructive pulmonary disease, tumor, diabetes, or renal failure but not dementia. When adjusted for age, gender, comorbidities, and main diagnosis, the 30-day mortality (P = .002) and length of stay (P = .001) were significantly higher in patients with monocytosis. The 30-day mortality in patients with monocytosis was most notably influenced by a cardiological diagnosis (odds ratio 3.91). An increased monocyte count predicts adverse outcome in patients admitted to the emergency department. Mechanistic studies will be necessary to specify the potentially detrimental role of monocytosis in critical illness.
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spelling pubmed-55157482017-07-28 Peripheral monocytosis as a predictive factor for adverse outcome in the emergency department: Survey based on a register study Hensel, Mathias Grädel, Lena Kutz, Alexander Haubitz, Sebastian Huber, Andreas Mueller, Beat Schuetz, Philipp Hügle, Thomas Medicine (Baltimore) 4100 Monocytosis is associated with chronic infections such as tuberculosis or endocarditis as well as rheumatic and myeloproliferative disorders. Monocytes are also involved in the pathogenesis of atherosclerosis, coronary artery disease, and stroke. The value of monocytosis as a prognostic marker in different diagnostic groups in the emergency setting, however, has not been investigated so far. The aim of the article is to study monocytosis as an outcome factor in the emergency setting. In a Swiss register study, we analyzed monocyte counts in 4238 patients aged >18 years who were admitted to the emergency department of a regional tertiary care hospital. Monocytosis was defined as 0.8×10(9) cells/L. Diagnoses were grouped into infection, cardiovascular, neurological, metabolic, gastrointestinal, pulmonary, or other. Thirty-day mortality was defined as the primary endpoint A total of 1217 patients with monocytosis were identified. Patients with monocytosis at admission suffered more frequently from respiratory symptoms (17.7% vs 8.9%, P <.001) and infection as the final diagnosis (20.8% vs 10.3%, P <.001) while neurological diagnoses were significantly lower in the monocytosis group (15.3% vs 30.9%, P <.001). Patients with monocytosis suffered from more comorbidities such as congestive heart failure, chronic obstructive pulmonary disease, tumor, diabetes, or renal failure but not dementia. When adjusted for age, gender, comorbidities, and main diagnosis, the 30-day mortality (P = .002) and length of stay (P = .001) were significantly higher in patients with monocytosis. The 30-day mortality in patients with monocytosis was most notably influenced by a cardiological diagnosis (odds ratio 3.91). An increased monocyte count predicts adverse outcome in patients admitted to the emergency department. Mechanistic studies will be necessary to specify the potentially detrimental role of monocytosis in critical illness. Wolters Kluwer Health 2017-07-14 /pmc/articles/PMC5515748/ /pubmed/28700476 http://dx.doi.org/10.1097/MD.0000000000007404 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-No Derivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 4100
Hensel, Mathias
Grädel, Lena
Kutz, Alexander
Haubitz, Sebastian
Huber, Andreas
Mueller, Beat
Schuetz, Philipp
Hügle, Thomas
Peripheral monocytosis as a predictive factor for adverse outcome in the emergency department: Survey based on a register study
title Peripheral monocytosis as a predictive factor for adverse outcome in the emergency department: Survey based on a register study
title_full Peripheral monocytosis as a predictive factor for adverse outcome in the emergency department: Survey based on a register study
title_fullStr Peripheral monocytosis as a predictive factor for adverse outcome in the emergency department: Survey based on a register study
title_full_unstemmed Peripheral monocytosis as a predictive factor for adverse outcome in the emergency department: Survey based on a register study
title_short Peripheral monocytosis as a predictive factor for adverse outcome in the emergency department: Survey based on a register study
title_sort peripheral monocytosis as a predictive factor for adverse outcome in the emergency department: survey based on a register study
topic 4100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5515748/
https://www.ncbi.nlm.nih.gov/pubmed/28700476
http://dx.doi.org/10.1097/MD.0000000000007404
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