Reduced lymphocyte count as an early marker for predicting infected pancreatic necrosis

BMC Gastroenterology

Jieshou Li¹  Ning Li¹  Weiqin Li²  Zhihui Tong²  Baiqiang Li²  Lei Zou²  Lu Ke²  Jing Sun¹  Xiao Shen² 

[1] Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 Zhongshan East Road, Nanjing 210002, Jiangsu Province, China;Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 Zhongshan East Road, Nanjing 210002, Jiangsu Province, China

关键词: Immunosuppression;    Lymphocyte count;    Infected pancreatic necrosis;    Acute pancreatitis;   

Others  :  1234330
DOI  :  10.1186/s12876-015-0375-2

 received in 2015-01-28, accepted in 2015-10-14,  发布年份 2015

【 摘 要 】

Background

Early occurrence of immunosuppression is a risk factor for infected pancreatic necrosis (IPN) in the patients with acute pancreatitis (AP). However, current measures for the immune systems are too cumbersome and not widely available. Significantly decreased lymphocyte count has been shown in patients with severe but not mild type of AP. Whereas, the correlation between the absolute lymphocyte count and IPN is still unknown. We conduct this study to reveal the exact relationship between early lymphocyte count and the development of IPN in the population of AP patients.

Methods

One hundred and fifty-three patients with acute pancreatitis admitted to Jinling Hospital during the period of January 2012 to July 2014 were included in this retrospective study. The absolute lymphocyte count and other relevant parameters were measured on admission. The diagnosis of IPN was based on the definition of the revised Atlanta classification.

Results

Patients were divided into two groups according to the presence of IPN. Thirty patients developed infected necrotizing pancreatitis during the disease course. The absolute lymphocyte count in patients with IPN was significantly lower on admission (0.62 × 10 ⁹ /L, interquartile range [IQR]: 0.46–0.87 × 10 ⁹ /L vs. 0.91 × 10 ⁹ /L, IQR: 0.72–1.27 × 10 ⁹ /L, p < 0.001) and throughout the whole clinical course than those without IPN. Logistic regression indicated that reduced lymphocyte count was an independent risk factor for IPN. The optimal cut-offs from ROC curve was 0.66 × 10 ⁹ /L giving sensitivity of 83.7 % and specificity of 66.7 %.

Conclusions

Reduced lymphocyte count within 48 h of AP onset is significantly and independently associated with the development of IPN.

【 授权许可】

   
2015 Shen et al.

【 图 表 】

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