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Título:	Lymphocytopenia as a Predictor of Mortality in Patients with ICU-Acquired Pneumonia
Autor/a:	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
Notas:	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.
Materia(s):	-Pneumònia adquirida a la comunitat -Mortalitat -Community-acquired pneumonia -Mortality
Derechos:	cc by (c) Ceccato et al., 2019 http://creativecommons.org/licenses/by/3.0/es/
Tipo de documento:	Artículo Artículo - Versión publicada
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