Lymphopaenia in cardiac arrest patients

Background: A decrease in circulating lymphocytes has been described as a marker of poor prognosis after septic shock; however, scarce data are available after cardiac arrest (CA). The aim of this study was to evaluate the impact of lymphopaenia after successful cardiopulmonary resuscitation. Methods: This is a retrospective analysis of an institutional database including all adult CA patients admitted to the intensive care unit (ICU) between January 2007 and December 2014 who survived for at least 24 h. Demographic, CA-related data and ICU mortality were recorded as was lymphocyte count on admission and for the first 48 h. A cerebral performance category score of 3–5 at 3 months was considered as an unfavourable neurological outcome. Results: Data from 377 patients were analysed (median age: 62 [IQRs: 52–75] years). Median time to return of spontaneous circulation (ROSC) was 15 [8–25] min and 232 (62%) had a non-shockable initial rhythm. ICU mortality was 58% (n = 217) and 246 (65%) patients had an unfavourable outcome at 3 months. The median lymphocyte count on admission was 1208 [700–2350]/mm3 and 151 (40%) patients had lymphopaenia (lymphocyte count <1000/mm3). Predictors of lymphopaenia on admission were older age, a shorter time to ROSC, prior use of corticosteroid therapy and high C-reactive protein levels on admission. ICU non-survivors had lower lymphocyte counts on admission than survivors (1100 [613–2317] vs. 1316 [891–2395]/mm3; p = 0.05) as did patients with unfavourable compared to those with favourable neurological outcomes (1100 [600–2013] vs. 1350 [919–2614]/mm3; p = 0.003). However, lymphopaenia on admission was not an independent predictor of poor outcomes in the entire population, but only among OHCA patients. Conclusions: A low lymphocyte count is common in CA survivors and is associated with poor outcome after OHCA.

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PID https://www.doi.org/10.1186/s13613-017-0308-z
PID pmid:28808927
PID pmc:PMC5555958
URL https://dx.doi.org/10.1186/s13613-017-0308-z
URL http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/259619
URL https://academic.microsoft.com/#/detail/2746971524
URL https://core.ac.uk/display/154268155
URL https://doaj.org/toc/2110-5820
URL https://pubmed.ncbi.nlm.nih.gov/28808927/
URL https://link.springer.com/article/10.1186/s13613-017-0308-z
URL http://dx.doi.org/10.1186/s13613-017-0308-z
URL https://annalsofintensivecare.springeropen.com/track/pdf/10.1186/s13613-017-0308-z
URL http://hdl.handle.net/11365/1022758
URL https://usiena-air.unisi.it/handle/11365/1022758
URL http://link.springer.com/article/10.1186/s13613-017-0308-z/fulltext.html
URL http://link.springer.com/article/10.1186/s13613-017-0308-z
URL https://paperity.org/p/81246376/lymphopaenia-in-cardiac-arrest-patients
URL https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-017-0308-z
URL https://difusion.ulb.ac.be/vufind/Record/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/259619/Holdings
URL http://link.springer.com/content/pdf/10.1186/s13613-017-0308-z.pdf
URL http://europepmc.org/articles/PMC5555958
URL https://www.ncbi.nlm.nih.gov/pubmed/28808927
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Access Right Open Access
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Author Savino Spadaro, 0000-0001-5027-5318
Author Jean-Louis Vincent, 0000-0001-6011-6951
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Collected From Europe PubMed Central; PubMed Central; ORCID; Datacite; UnpayWall; DOAJ-Articles; Crossref; DI-fusion; Microsoft Academic Graph; Usiena air - Università di Siena
Hosted By Europe PubMed Central; DI-fusion; Annals of Intensive Care; Usiena air - Università di Siena
Publication Date 2017-08-01
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Country Belgium; Italy
Description SCOPUS: ar.j
Description info:eu-repo/semantics/inPress
Format 1 full-text file(s): application/pdf
Language English
Resource Type Article; UNKNOWN
keyword Cardiac arrest; Lymphopaenia; Outcome; Prognosis; Critical Care and Intensive Care Medicine
system:type publication
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Source https://science-innovation-policy.openaire.eu/search/publication?articleId=dedup_wf_001::5ce2876a40d7167aeb6f0f57f8aa6e68
Author jsonws_user
Last Updated 26 December 2020, 19:44 (CET)
Created 26 December 2020, 19:44 (CET)