Postoperative lymphopenia: An independent risk factor for postoperative pneumonia after lung cancer surgery, results of a case-control study.
Postoperative lymphopenia: An independent risk factor for postoperative pneumonia after lung cancer surgery, results of a case-control study.
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DOI：
10.1371/journal.pone.0205237
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Molliex S
中科院分区：
文献类型：
--
作者：
Dupont G;Flory L;Morel J;Lukaszewicz AC;Patoir A;Presles E;Monneret G;Molliex S
术后淋巴细胞减少症已被认为是术后感染的一个危险因素，但在多变量分析中从未被确定。术后肺炎（POP）是肺癌手术后最常见的并发症之一，并与更差的结局相关。我们的目的是评估肺癌手术后淋巴细胞减少症与POP之间的关系。因肺癌手术（肺叶切除术、双叶切除术或全肺切除术）而入院的患者，年龄≥ 18岁且无免疫抑制状态史，符合入选条件。在手术前一天和术后第1、3和7天抽取血液，测定淋巴细胞计数。POP的诊断基于临床、生物学和放射学数据。根据目前描述的POP风险因素调整的logistic回归模型用于解释这种情况的发生。纳入200例患者，其中43例（21.5%）发生POP。术前淋巴细胞计数分别为1.8±0.6x109个细胞/L和2.0±0.7x109个细胞/L（P = 0.091）。在两组中，淋巴细胞计数最低值发生在术后第1天。在多变量分析中，术后第1天淋巴细胞减少与POP风险增加显著相关（比值比：2.63，95%CI [1.03-5.40]）。术后第1天淋巴细胞计数较低（≤1.19x109个细胞/L）的患者术后第7天的POP率较高（P = .003）。我们的研究表明，肺癌手术后淋巴细胞减少症在术后第1天最严重，并与POP相关。
Postoperative lymphopenia has been proposed as a risk factor for postoperative infections but has never been identified as such in a multivariate analysis. Postoperative pneumonia (POP) is one of the most common complications after lung cancer surgery and is associated with a worse outcome. We aimed to evaluate the association between postoperative lymphopenia and POP after lung cancer surgery. Patients admitted for lung cancer surgery (lobectomy, bilobectomy, or pneumonectomy) aged ≥ 18 years and with no history of an immunosuppressive state were eligible for inclusion. Lymphocyte counts were determined in blood drawn on the day before surgery and at postoperative days 1, 3 and 7. POP diagnosis was based on clinical, biological and radiological data. A logistic regression model adjusted on currently described risk factors for POP was used to explain the onset of this condition. Two hundred patients were included, of whom 43 (21.5%) developed POP. Preoperative lymphocyte count was 1.8±0.6x109 cells/L and 2.0±0.7x109 cells/L in patients with and without POP, respectively (P = .091). In both groups, the lymphocyte count nadir occurred at postoperative day 1. In multivariate analysis, lymphopenia at postoperative day 1 was significantly associated with increased risk of POP (odds ratio: 2.63, 95% CI [1.03–5.40]). POP rate at postoperative day 7 was higher in patients presenting low lymphocyte counts (≤1.19x109 cells/L) at postoperative day 1 (P = .003). Our study showed that lymphopenia following lung cancer surgery was maximal at postoperative day 1 and was associated with POP.
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影响因子：
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作者：
Takahashi, J;Shono, Y;Kato, H
通讯作者：
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DOI：
10.1164/rccm.200510-1556oc
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