Relation between lymphopenia and bacteraemia in UK adults with medical emergencies
Relation between lymphopenia and bacteraemia in UK adults with medical emergencies
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DOI：
10.1136/jcp.2004.017335
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发表时间：
2004-09-01
影响因子：
3.4
通讯作者：
Peto, TEA
中科院分区：
文献类型：
--
作者：
Wyllie, DH;Bowler, ICJW;Peto, TEA
目的：确定在急诊入院的患者中，淋巴细胞减少与菌血症诊断的相关性，与外周血白细胞计数和中性粒细胞的相关性。患者/方法：在英国牛津的一家教学医院进行了一项为期两年的队列研究，连续21495名成人在普通内科或传染病病房急诊住院。有21372例患者可获得全血数据；41例血细胞计数极高的患者(中性粒细胞计数，75x10(9)/升；淋巴细胞计数，10x10(9)/升)被排除在外，剩下21331例进行分析。分析入院淋巴细胞和中性粒细胞计数与菌血症风险的关系。结果：中性粒细胞增多和淋巴细胞减少均与菌血症有关。在这个队列中，淋巴细胞减少是更好的预测指标。结论：可疑菌血症患者入院时应考虑淋巴细胞和中性粒细胞计数，而不是白细胞总数。
Aims: To determine the relevance of lymphopenia to the diagnosis of bacteraemia in patients admitted with medical emergencies, relative to peripheral blood white cell count and neutrophilia.Patients/Methods: A two year cohort study carried out in a teaching hospital in Oxford, UK of 21 495 consecutive adult emergency admissions to general medical or infectious disease wards. Full blood data were available in 21372 cases; 41 cases with extreme full blood count results (neutrophil count, >75x10(9)/litre; lymphocyte count, >10x10(9)/litre) were excluded, leaving 21331 cases for analysis. The association between the admission lymphocyte and neutrophil counts and the risk of bacteraemia was assessed.Results: Neutrophilia and lymphopenia were both associated with bacteraemia. Lymphopenia was the better predictor in this cohort. Both neutrophilia and lymphopenia were more predictive of bacteraemia than the total white blood cell count.Conclusions: Both lymphocyte and neutrophil counts, rather than total white blood cell count, should be considered in adult medical admissions with suspected bacteraemia.