• Lei Xue, Qian-Mei Sun, Han Yu, Yang-Hong Liang, and Chun-Sheng Li.
• Department of Geriatric Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
• J Coll Physicians Surg Pak. 2019 Dec 1; 29 (12): 1144-1148.

ObjectiveTo detect relationship between cellular immunity changes and prognosis in elderly patients with sepsis.Study DesignAn observational study.Place And Duration Of StudyGeneral Department and Emergency Care Unit, Beijing Chaoyang Hospital, Beijing, China, from January to December 2016.MethodologyPatients who had infection were included in this study, and divided into two groups; those with sepsis and no sepsis. One hundred and forty-one healthy volunteers were chosen to enroll in this study just as a control (control group). Patients were excluded if they were younger than 18 years of age; had hematological or immunological disease; had uncontrolled diabetes; and pretreated with immunosuppressive agents. Patients were further grouped according to age, their T lymphocyte subsets were compared, and their acute physiology and chronic health evaluation II (APACHE II) scores were compared. The 28-day re-hospitalisation rate was followed-up, and the effects of T lymphocyte subsets and APACHE II scores on this rate were statistical analysed.ResultsOut of the 687 patients, 350 patients had sepsis (sepsis group), and 337 patients had no sepsis (non-sepsis group). The age of these patients ranged from 19-96 years. CD3+T, CD4+T, CD8+T and natural NK cells were significantly lower in the elderly population, (p< 0.01). CD3+T, CD4+T, CD8+T and NK cells were significantly lower in the sepsis group, compared with patients in the non-sepsis group and control group; and the differences were statistically significant (p<0.05), while APACHE II score was significantly higher (p<0.01). In the sepsis group, compared with the non-elderly population, CD3+T, CD4+T and NK cells were significantly lower in the elderly population; and the differences were statistically significant (p<0.05), while APACHE II score was significantly higher (p<0.05). The 28-day re-hospitalisation rate was associated with CD3+T, CD4+T, CD8+T cells and APACHE II scores (p<0.05).ConclusionCD3+T, CD4+T, CD8+T cells and APACHE II scores can be used as independent predictors of the 28-day re-hospitalisation rate.

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