A Leligdowicz

A Linkermann

A Ortega-Gómez

AA Quartin

AC Lukaszewicz

AJ Grau

AM Burns

AM Drewry

AP West

C Nathan

CP Jager de

DE Wesche

Didier Payen

DL Bratton

E Kolaczkowska

Etienne Gayat

Florence Riché

G Malietzis

GP Otto

H Xiao

J Vincent

JC Marshall

JD Salciccioli

JL Vincent

JM Cavaillon

Joaquim Matéo

JR Gall Le

JS Boomer

K Chang

K Tschaikowsky

LC Lemaire

Matthieu Le Dorze

ME Charlson

MF Osuchowski

MM Levy

PG Vaughan-Shaw

PM Roger

R Zahorec

Romain Barthélémy

RS Hotchkiss

S Yende

T Motomura

TC Horan

TM Perl

W Xiao

WL Macias

Y Tulzo Le

Abstract
                Introduction
                Septic shock is one of the most frequent causes of admission to the intensive care unit (ICU) and is associated with a poor prognosis. Early and late death in septic shock should be distinguished because they may involve different underlying mechanisms. In various conditions, the neutrophil-to-lymphocyte count ratio (NLCR) has been described as an easily measurable parameter to express injury severity. In the present study, we investigated whether the timing of death was related to a particular NLCR.
              
                Methods
                We conducted a prospective, single-center, observational study that included consecutive septic shock patients. Severity scores, early (before day 5) or late (on or after day 5 of septic shock onset) ICU mortality, and daily leukocyte counts were collected during the ICU stay. We assessed the association between leukocyte counts at admission and their evolution during the first 5 days with early or late death. The association between patient characteristics (including cell counts) and prognosis was estimated using Cox proportional cause-specific hazards models.
              
                Results
                The study included 130 patients who were diagnosed with abdominal (n = 99) or extra-abdominal (n = 31) septic shock. The median (interquartile range) NLCR was 12.5 (6.5–21.2) in survivors and 6.2 (3.7–12.6) in nonsurvivors (p = 0.001). The NLCR at admission was significantly lower in patients who died before day 5 than in survivors (5 [3.5–11.6] versus 12.5 [6.5–21.2], respectively; p = 0.01). From day 1 to day 5, an increased NLCR related to an increase in neutrophil count and a decrease in lymphocyte count was associated with late death (+34.8 % [−8.2 to 305.4] versus −20 % [−57.4 to 45.9]; p = 0.003). Those results were present in patients with abdominal origin sepsis as well as in those with extra-abdominal sepsis, who were analyzed separately.
              
                Conclusions
                In the present study, a reversed NLCR evolution was observed according to the timing of death. Septic shock patients at risk of early death had a low NLCR at admission, although late death was associated with an increased NLCR during the first 5 days.
              </jats:sec

Crossref

Critical Care

Reversal of neutrophil-to-lymphocyte count ratio in early versus late death from septic shock

https://ccforum.biomedcentral.com/track/pdf/10.1186/s13054-015-1144-x?site=ccforum.biomedcentral.com

Reversal of neutrophil-to-lymphocyte count ratio in early versus late death from septic shock

Abstract

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