Evaluation of a combination “lymphocyte apoptosis model” to predict survival of sepsis patients in an intensive care unit
Abstract Background A major challenge in sepsis intervention is unclear risk stratification. We postulated that a panel of biomarkers of lymphocyte apoptosis and immune function, termed the “lymphocyte apoptosis model,” would be an effective tool for predicting 28-day survival for sepsis patients. M...
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| Format: | Article |
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BMC
2018-07-01
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| Series: | BMC Anesthesiology |
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| Online Access: | http://link.springer.com/article/10.1186/s12871-018-0535-3 |
| _version_ | 1818254233987710976 |
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| author | Wenqiang Jiang Wenhong Zhong Yiyu Deng Chunbo Chen Qiaosheng Wang Maohua Zhou Xusheng Li Cheng Sun Hongke Zeng |
| author_facet | Wenqiang Jiang Wenhong Zhong Yiyu Deng Chunbo Chen Qiaosheng Wang Maohua Zhou Xusheng Li Cheng Sun Hongke Zeng |
| author_sort | Wenqiang Jiang |
| collection | DOAJ |
| description | Abstract Background A major challenge in sepsis intervention is unclear risk stratification. We postulated that a panel of biomarkers of lymphocyte apoptosis and immune function, termed the “lymphocyte apoptosis model,” would be an effective tool for predicting 28-day survival for sepsis patients. Methods A total of 52 consecutive sepsis patients were enrolled. Peripheral blood samples were collected on day 1 of admission for quantification of biomarkers of lymphocyte apoptosis and immune function, including lymphocyte count, lymphocyte apoptotic percentage, expression on monocyte HLA-DR, CD4+/CD8+ T cell ratio, T helper type 1 to type 2 ratio (Th1/Th2), cytochrome c levels, and various proinflammatory cytokine levels. Sepsis severity was classified using Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores. Survival was assessed at 28 days. Results Compared with survivors, non-survivors had significantly higher lymphocyte apoptotic percentages and plasma cytochrome c levels and significantly lower lymphocyte counts, Th1/Th2 ratios, and HLA-DR expression on day 1 of admission. Multivariate analysis identified cytochrome c levels (odds ratio [OR]1.829, p = 0.025), lymphocyte apoptotic percentage (OR 1.103, p = 0.028), lymphocyte count (OR 0.150, p = 0.047), and HLA-DR expression (OR 0.923, p = 0.021) as independent predictors of 28-day mortality. A logistic regression equation incorporating the independent risk factors predicted 28-day mortality with greater accuracy than did the APACHE II score or single components biomarkers. Conclusions The “lymphocyte apoptosis model” may be useful for risk stratification and predicting prognosis of sepsis patients. |
| first_indexed | 2024-12-12T16:52:43Z |
| format | Article |
| id | doaj.art-53a6d67a74f345a6a89d97ad52872951 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-12T16:52:43Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-53a6d67a74f345a6a89d97ad528729512022-12-22T00:18:19ZengBMCBMC Anesthesiology1471-22532018-07-0118111010.1186/s12871-018-0535-3Evaluation of a combination “lymphocyte apoptosis model” to predict survival of sepsis patients in an intensive care unitWenqiang Jiang0Wenhong Zhong1Yiyu Deng2Chunbo Chen3Qiaosheng Wang4Maohua Zhou5Xusheng Li6Cheng Sun7Hongke Zeng8The Second School of Clinical Medicine, Southern Medical UniversityThe Second School of Clinical Medicine, Southern Medical UniversityDepartment of Emergency and Critical Care Medicine, Guangdong General Hospital, Guangdong Academy of Medical SciencesDepartment of Emergency and Critical Care Medicine, Guangdong General Hospital, Guangdong Academy of Medical SciencesThe Second School of Clinical Medicine, Southern Medical UniversityDivision of Laboratory, Guangdong General Hospital, Guangdong Academy of Medical SciencesThe Second School of Clinical Medicine, Southern Medical UniversityDepartment of Emergency and Critical Care Medicine, Guangdong General Hospital, Guangdong Academy of Medical SciencesThe Second School of Clinical Medicine, Southern Medical UniversityAbstract Background A major challenge in sepsis intervention is unclear risk stratification. We postulated that a panel of biomarkers of lymphocyte apoptosis and immune function, termed the “lymphocyte apoptosis model,” would be an effective tool for predicting 28-day survival for sepsis patients. Methods A total of 52 consecutive sepsis patients were enrolled. Peripheral blood samples were collected on day 1 of admission for quantification of biomarkers of lymphocyte apoptosis and immune function, including lymphocyte count, lymphocyte apoptotic percentage, expression on monocyte HLA-DR, CD4+/CD8+ T cell ratio, T helper type 1 to type 2 ratio (Th1/Th2), cytochrome c levels, and various proinflammatory cytokine levels. Sepsis severity was classified using Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores. Survival was assessed at 28 days. Results Compared with survivors, non-survivors had significantly higher lymphocyte apoptotic percentages and plasma cytochrome c levels and significantly lower lymphocyte counts, Th1/Th2 ratios, and HLA-DR expression on day 1 of admission. Multivariate analysis identified cytochrome c levels (odds ratio [OR]1.829, p = 0.025), lymphocyte apoptotic percentage (OR 1.103, p = 0.028), lymphocyte count (OR 0.150, p = 0.047), and HLA-DR expression (OR 0.923, p = 0.021) as independent predictors of 28-day mortality. A logistic regression equation incorporating the independent risk factors predicted 28-day mortality with greater accuracy than did the APACHE II score or single components biomarkers. Conclusions The “lymphocyte apoptosis model” may be useful for risk stratification and predicting prognosis of sepsis patients.http://link.springer.com/article/10.1186/s12871-018-0535-3SepsisLymphocyte apoptosisImmune functionBiomarkerPredictive modelPrognosis |
| spellingShingle | Wenqiang Jiang Wenhong Zhong Yiyu Deng Chunbo Chen Qiaosheng Wang Maohua Zhou Xusheng Li Cheng Sun Hongke Zeng Evaluation of a combination “lymphocyte apoptosis model” to predict survival of sepsis patients in an intensive care unit BMC Anesthesiology Sepsis Lymphocyte apoptosis Immune function Biomarker Predictive model Prognosis |
| title | Evaluation of a combination “lymphocyte apoptosis model” to predict survival of sepsis patients in an intensive care unit |
| title_full | Evaluation of a combination “lymphocyte apoptosis model” to predict survival of sepsis patients in an intensive care unit |
| title_fullStr | Evaluation of a combination “lymphocyte apoptosis model” to predict survival of sepsis patients in an intensive care unit |
| title_full_unstemmed | Evaluation of a combination “lymphocyte apoptosis model” to predict survival of sepsis patients in an intensive care unit |
| title_short | Evaluation of a combination “lymphocyte apoptosis model” to predict survival of sepsis patients in an intensive care unit |
| title_sort | evaluation of a combination lymphocyte apoptosis model to predict survival of sepsis patients in an intensive care unit |
| topic | Sepsis Lymphocyte apoptosis Immune function Biomarker Predictive model Prognosis |
| url | http://link.springer.com/article/10.1186/s12871-018-0535-3 |
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