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Lymphopenia in hospitalized patients and its relationship with severity of illness and mortality

BACKGROUND: Lymphopenia is associated with various pathologies such as sepsis, burns, trauma, general anesthesia and major surgeries. All these pathologies are clinically expressed by the so-called Systemic Inflammatory Response Syndrome which does not include lymphopenia into defining criteria. The...

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Autores principales: Andreu-Ballester, Juan Carlos, Pons-Castillo, Aurelio, González-Sánchez, Antonio, Llombart-Cussac, Antonio, Cano, María José, Cuéllar, Carmen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8362940/
https://www.ncbi.nlm.nih.gov/pubmed/34388210
http://dx.doi.org/10.1371/journal.pone.0256205
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author Andreu-Ballester, Juan Carlos
Pons-Castillo, Aurelio
González-Sánchez, Antonio
Llombart-Cussac, Antonio
Cano, María José
Cuéllar, Carmen
author_facet Andreu-Ballester, Juan Carlos
Pons-Castillo, Aurelio
González-Sánchez, Antonio
Llombart-Cussac, Antonio
Cano, María José
Cuéllar, Carmen
author_sort Andreu-Ballester, Juan Carlos
collection PubMed
description BACKGROUND: Lymphopenia is associated with various pathologies such as sepsis, burns, trauma, general anesthesia and major surgeries. All these pathologies are clinically expressed by the so-called Systemic Inflammatory Response Syndrome which does not include lymphopenia into defining criteria. The main objective of this work was to analyze the diagnosis of patients admitted to a hospital related to lymphopenia during hospital stay. In addition, we investigated the relationship of lymphopenia with the four levels of the Severity of Illness (SOI) and the Risk of Mortality (ROM). METHOD AND FINDINGS: Lymphopenia was defined as Absolute Lymphocyte Count (ALC) <1.0 x10(9)/L. ALC were analyzed every day since admission. The four levels (minor, moderate, major and extreme risk) of both SOI and ROM were assessed. A total of 58,260 hospital admissions were analyzed. More than 41% of the patients had lymphopenia during hospital stay. The mean time to death was shorter among patients with lymphopenia on admission 65.6 days (CI95%, 57.3–73.8) vs 89.9 (CI95%, 82.4–97.4), P<0.001. Also, patients with lymphopenia during hospital stay had a shorter time to the mortality, 67.5 (CI95%, 61.1–73.9) vs 96.9 (CI95%, 92.6–101.2), P<0.001. CONCLUSIONS: Lymphopenia had a high prevalence in hospitalized patients with greater relevance in infectious pathologies. Lymphopenia was related and clearly predicts SOI and ROM at the time of admission, and should be considered as clinical diagnostic criteria to define SIRS.
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spelling pubmed-83629402021-08-14 Lymphopenia in hospitalized patients and its relationship with severity of illness and mortality Andreu-Ballester, Juan Carlos Pons-Castillo, Aurelio González-Sánchez, Antonio Llombart-Cussac, Antonio Cano, María José Cuéllar, Carmen PLoS One Research Article BACKGROUND: Lymphopenia is associated with various pathologies such as sepsis, burns, trauma, general anesthesia and major surgeries. All these pathologies are clinically expressed by the so-called Systemic Inflammatory Response Syndrome which does not include lymphopenia into defining criteria. The main objective of this work was to analyze the diagnosis of patients admitted to a hospital related to lymphopenia during hospital stay. In addition, we investigated the relationship of lymphopenia with the four levels of the Severity of Illness (SOI) and the Risk of Mortality (ROM). METHOD AND FINDINGS: Lymphopenia was defined as Absolute Lymphocyte Count (ALC) <1.0 x10(9)/L. ALC were analyzed every day since admission. The four levels (minor, moderate, major and extreme risk) of both SOI and ROM were assessed. A total of 58,260 hospital admissions were analyzed. More than 41% of the patients had lymphopenia during hospital stay. The mean time to death was shorter among patients with lymphopenia on admission 65.6 days (CI95%, 57.3–73.8) vs 89.9 (CI95%, 82.4–97.4), P<0.001. Also, patients with lymphopenia during hospital stay had a shorter time to the mortality, 67.5 (CI95%, 61.1–73.9) vs 96.9 (CI95%, 92.6–101.2), P<0.001. CONCLUSIONS: Lymphopenia had a high prevalence in hospitalized patients with greater relevance in infectious pathologies. Lymphopenia was related and clearly predicts SOI and ROM at the time of admission, and should be considered as clinical diagnostic criteria to define SIRS. Public Library of Science 2021-08-13 /pmc/articles/PMC8362940/ /pubmed/34388210 http://dx.doi.org/10.1371/journal.pone.0256205 Text en © 2021 Andreu-Ballester et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Andreu-Ballester, Juan Carlos
Pons-Castillo, Aurelio
González-Sánchez, Antonio
Llombart-Cussac, Antonio
Cano, María José
Cuéllar, Carmen
Lymphopenia in hospitalized patients and its relationship with severity of illness and mortality
title Lymphopenia in hospitalized patients and its relationship with severity of illness and mortality
title_full Lymphopenia in hospitalized patients and its relationship with severity of illness and mortality
title_fullStr Lymphopenia in hospitalized patients and its relationship with severity of illness and mortality
title_full_unstemmed Lymphopenia in hospitalized patients and its relationship with severity of illness and mortality
title_short Lymphopenia in hospitalized patients and its relationship with severity of illness and mortality
title_sort lymphopenia in hospitalized patients and its relationship with severity of illness and mortality
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8362940/
https://www.ncbi.nlm.nih.gov/pubmed/34388210
http://dx.doi.org/10.1371/journal.pone.0256205
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