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

BMC Gastroenterology

Research Article

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

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

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

DOI  :  10.1186/s12876-015-0375-2

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

来源: Springer

【 摘 要 】

BackgroundEarly 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.MethodsOne 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.ResultsPatients 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 × 109/L, interquartile range [IQR]: 0.46–0.87 × 109/L vs. 0.91 × 109/L, IQR: 0.72–1.27 × 109/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 × 109/L giving sensitivity of 83.7 % and specificity of 66.7 %.ConclusionsReduced lymphocyte count within 48 h of AP onset is significantly and independently associated with the development of IPN.

【 授权许可】

CC BY   
© Shen et al. 2015