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Nonviral infection-related lymphocytopenia for the prediction of adult sepsis and its persistence indicates a higher mortality
Sepsis is a life-threatening disease that affects 30 million people worldwide each year. Despite the rapid advances in medical technology and organ support systems, it is still difficult to reduce the mortality rate. Early and rapid diagnosis is crucial to improve the treatment outcome. The aim of t...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708870/ https://www.ncbi.nlm.nih.gov/pubmed/31335735 http://dx.doi.org/10.1097/MD.0000000000016535 |
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author | Jiang, Jie Du, Huimin Su, Yanxin Li, Xin Zhang, Jing Chen, Meihao Ren, Guosheng He, Faming Niu, Bailin |
author_facet | Jiang, Jie Du, Huimin Su, Yanxin Li, Xin Zhang, Jing Chen, Meihao Ren, Guosheng He, Faming Niu, Bailin |
author_sort | Jiang, Jie |
collection | PubMed |
description | Sepsis is a life-threatening disease that affects 30 million people worldwide each year. Despite the rapid advances in medical technology and organ support systems, it is still difficult to reduce the mortality rate. Early and rapid diagnosis is crucial to improve the treatment outcome. The aim of this study was to investigate the prediction efficiency of lymphopenia and other clinical markers, such as white blood cell (WBC), neutrophil count (N#), procalcitonin (PCT), and arterial lactic acid (Lac) in the diagnosis and prognosis assessment for adult patients with nonviral infection-related sepsis. A total of 77 sepsis- and 23 non-sepsis adult patients were enrolled in this study from September 2016 to September 2018. Daily lymphocyte count (Lym) of the patients was calculated until discharge or death. The diagnostic performance of the Lym and other biomarkers were compared using the area under the receiver operating characteristic curve (ROC) value. The level of Lym was decreased significantly in the sepsis group. Lym had a high diagnostic performance for sepsis, with an area under the curve (AUC) value of 0.971 (95% CI = 0.916–0.994). The diagnostic efficacy of Lym was more significant than WBC, N#, and PCT (P < .001). The results showed that the 28-day mortality rate of patients with continuous Lym <0.76 × 10(9)/L was 39.66%, which significantly higher than patients without persistent lymphocytopenia. Lym is a promising, low cost, fast, and easily available biomarker for the diagnosis of sepsis. When nonviral infection is suspected and lymphocytopenia level is lower than the optimal cut-off (0.76 × 10(9)/L) value, high vigilance is required for sepsis. The persistence with the lymphocytopenia cut-off value (<0.76 × 10(9)/L) >3 days indicates a higher 28-day mortality rate. |
format | Online Article Text |
id | pubmed-6708870 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-67088702019-10-01 Nonviral infection-related lymphocytopenia for the prediction of adult sepsis and its persistence indicates a higher mortality Jiang, Jie Du, Huimin Su, Yanxin Li, Xin Zhang, Jing Chen, Meihao Ren, Guosheng He, Faming Niu, Bailin Medicine (Baltimore) Research Article Sepsis is a life-threatening disease that affects 30 million people worldwide each year. Despite the rapid advances in medical technology and organ support systems, it is still difficult to reduce the mortality rate. Early and rapid diagnosis is crucial to improve the treatment outcome. The aim of this study was to investigate the prediction efficiency of lymphopenia and other clinical markers, such as white blood cell (WBC), neutrophil count (N#), procalcitonin (PCT), and arterial lactic acid (Lac) in the diagnosis and prognosis assessment for adult patients with nonviral infection-related sepsis. A total of 77 sepsis- and 23 non-sepsis adult patients were enrolled in this study from September 2016 to September 2018. Daily lymphocyte count (Lym) of the patients was calculated until discharge or death. The diagnostic performance of the Lym and other biomarkers were compared using the area under the receiver operating characteristic curve (ROC) value. The level of Lym was decreased significantly in the sepsis group. Lym had a high diagnostic performance for sepsis, with an area under the curve (AUC) value of 0.971 (95% CI = 0.916–0.994). The diagnostic efficacy of Lym was more significant than WBC, N#, and PCT (P < .001). The results showed that the 28-day mortality rate of patients with continuous Lym <0.76 × 10(9)/L was 39.66%, which significantly higher than patients without persistent lymphocytopenia. Lym is a promising, low cost, fast, and easily available biomarker for the diagnosis of sepsis. When nonviral infection is suspected and lymphocytopenia level is lower than the optimal cut-off (0.76 × 10(9)/L) value, high vigilance is required for sepsis. The persistence with the lymphocytopenia cut-off value (<0.76 × 10(9)/L) >3 days indicates a higher 28-day mortality rate. Wolters Kluwer Health 2019-07-19 /pmc/articles/PMC6708870/ /pubmed/31335735 http://dx.doi.org/10.1097/MD.0000000000016535 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | Research Article Jiang, Jie Du, Huimin Su, Yanxin Li, Xin Zhang, Jing Chen, Meihao Ren, Guosheng He, Faming Niu, Bailin Nonviral infection-related lymphocytopenia for the prediction of adult sepsis and its persistence indicates a higher mortality |
title | Nonviral infection-related lymphocytopenia for the prediction of adult sepsis and its persistence indicates a higher mortality |
title_full | Nonviral infection-related lymphocytopenia for the prediction of adult sepsis and its persistence indicates a higher mortality |
title_fullStr | Nonviral infection-related lymphocytopenia for the prediction of adult sepsis and its persistence indicates a higher mortality |
title_full_unstemmed | Nonviral infection-related lymphocytopenia for the prediction of adult sepsis and its persistence indicates a higher mortality |
title_short | Nonviral infection-related lymphocytopenia for the prediction of adult sepsis and its persistence indicates a higher mortality |
title_sort | nonviral infection-related lymphocytopenia for the prediction of adult sepsis and its persistence indicates a higher mortality |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708870/ https://www.ncbi.nlm.nih.gov/pubmed/31335735 http://dx.doi.org/10.1097/MD.0000000000016535 |
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