Lymphocyte and NK Cell Counts Can Predict Sepsis-Associated Delirium in Elderly Patients
Background: Sepsis-associated delirium (SAD) is prevalent in elderly patients and is recognized as brain dysfunction associated with increased inflammatory response in the central nervous system during sepsis. Neuroinflammation was demonstrated to be part of its mechanism and we aimed to validate th...
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Frontiers Media S.A.
2021-01-01
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| Series: | Frontiers in Aging Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnagi.2020.621298/full |
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| author | Dongkai Li Jiahui Zhang Guangxu Bai Jianwei Chen Wei Cheng Na Cui |
| author_facet | Dongkai Li Jiahui Zhang Guangxu Bai Jianwei Chen Wei Cheng Na Cui |
| author_sort | Dongkai Li |
| collection | DOAJ |
| description | Background: Sepsis-associated delirium (SAD) is prevalent in elderly patients and is recognized as brain dysfunction associated with increased inflammatory response in the central nervous system during sepsis. Neuroinflammation was demonstrated to be part of its mechanism and we aimed to validate the role of immunity imbalance in a combined retrospective and prospective cohort study.Methods: We performed a retrospective study analyzing the association between SAD and lymphocyte counts in the peripheral blood, alongside a prospective trial evaluating the quantitative changes in lymphocyte subsets and their predictive value for early diagnosis of SAD.Results: In the retrospective study, among 1,010 enrolled adult patients (age ≥65 years), 297 patients were diagnosed with delirium during intensive care unit (ICU) stay and lymphocyte counts at ICU admission in the SAD group were significantly higher than in non-delirious counterparts (1.09 ± 0.32 vs. 0.82 ± 0.24, respectively, p = 0.001). In the prospective study, lymphocyte counts [0.83 (0.56, 1.15) vs. 0.72 (0.40, 1.06) × 109/L, p = 0.020] and natural killer (NK) cell counts [96 (68, 118) vs. 56 (26, 92) cells/μl, p = 0.024] were significantly higher in the SAD group. The area under the curve value of NK cell count was 0.895 [95% confidence interval (CI): 0.857, 0.933] and of lymphocyte count was 0.728 (95% CI: 0.662, 0.795). An NK cell count cut-off value of 87 cells/ml in septic patients at ICU admission was predictive of delirium with a sensitivity of 80.2% and specificity of 80.8%.Conclusions: We found that lymphocyte and NK cell counts were significantly higher in senior patients with SAD and that NK cell count may be valuable for the prediction of SAD within elderly patient cohorts. |
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| institution | Directory Open Access Journal |
| issn | 1663-4365 |
| language | English |
| last_indexed | 2024-12-17T08:24:16Z |
| publishDate | 2021-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Aging Neuroscience |
| spelling | doaj.art-05acd7b7d4ea4dce8e2cfb9983b0446d2022-12-21T21:56:49ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652021-01-011210.3389/fnagi.2020.621298621298Lymphocyte and NK Cell Counts Can Predict Sepsis-Associated Delirium in Elderly PatientsDongkai LiJiahui ZhangGuangxu BaiJianwei ChenWei ChengNa CuiBackground: Sepsis-associated delirium (SAD) is prevalent in elderly patients and is recognized as brain dysfunction associated with increased inflammatory response in the central nervous system during sepsis. Neuroinflammation was demonstrated to be part of its mechanism and we aimed to validate the role of immunity imbalance in a combined retrospective and prospective cohort study.Methods: We performed a retrospective study analyzing the association between SAD and lymphocyte counts in the peripheral blood, alongside a prospective trial evaluating the quantitative changes in lymphocyte subsets and their predictive value for early diagnosis of SAD.Results: In the retrospective study, among 1,010 enrolled adult patients (age ≥65 years), 297 patients were diagnosed with delirium during intensive care unit (ICU) stay and lymphocyte counts at ICU admission in the SAD group were significantly higher than in non-delirious counterparts (1.09 ± 0.32 vs. 0.82 ± 0.24, respectively, p = 0.001). In the prospective study, lymphocyte counts [0.83 (0.56, 1.15) vs. 0.72 (0.40, 1.06) × 109/L, p = 0.020] and natural killer (NK) cell counts [96 (68, 118) vs. 56 (26, 92) cells/μl, p = 0.024] were significantly higher in the SAD group. The area under the curve value of NK cell count was 0.895 [95% confidence interval (CI): 0.857, 0.933] and of lymphocyte count was 0.728 (95% CI: 0.662, 0.795). An NK cell count cut-off value of 87 cells/ml in septic patients at ICU admission was predictive of delirium with a sensitivity of 80.2% and specificity of 80.8%.Conclusions: We found that lymphocyte and NK cell counts were significantly higher in senior patients with SAD and that NK cell count may be valuable for the prediction of SAD within elderly patient cohorts.https://www.frontiersin.org/articles/10.3389/fnagi.2020.621298/fulldeliriumsepsis-associated deliriumlymphocyte subsetsNK cellelderly people |
| spellingShingle | Dongkai Li Jiahui Zhang Guangxu Bai Jianwei Chen Wei Cheng Na Cui Lymphocyte and NK Cell Counts Can Predict Sepsis-Associated Delirium in Elderly Patients Frontiers in Aging Neuroscience delirium sepsis-associated delirium lymphocyte subsets NK cell elderly people |
| title | Lymphocyte and NK Cell Counts Can Predict Sepsis-Associated Delirium in Elderly Patients |
| title_full | Lymphocyte and NK Cell Counts Can Predict Sepsis-Associated Delirium in Elderly Patients |
| title_fullStr | Lymphocyte and NK Cell Counts Can Predict Sepsis-Associated Delirium in Elderly Patients |
| title_full_unstemmed | Lymphocyte and NK Cell Counts Can Predict Sepsis-Associated Delirium in Elderly Patients |
| title_short | Lymphocyte and NK Cell Counts Can Predict Sepsis-Associated Delirium in Elderly Patients |
| title_sort | lymphocyte and nk cell counts can predict sepsis associated delirium in elderly patients |
| topic | delirium sepsis-associated delirium lymphocyte subsets NK cell elderly people |
| url | https://www.frontiersin.org/articles/10.3389/fnagi.2020.621298/full |
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