• Anne M Drewry, Brian M Fuller, Lee P Skrupky, and Richard S Hotchkiss.
• 1Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO. 2Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO. 3Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, MO. 4Department of Surgery, Washington University School of Medicine, St. Louis, MO.
• Crit. Care Med. 2015 Jun 1; 43 (6): 1165-9.

ObjectiveTo determine whether hypothermia within 24 hours of sepsis diagnosis is associated with development of persistent lymphopenia, a feature of sepsis-induced immunosuppression.DesignRetrospective cohort study.SettingA 1,200-bed university-affiliated tertiary care hospital.PatientsAdult patients diagnosed with bacteremia and sepsis within 5 days of hospital admission between January 1, 2010, and July 31, 2012.InterventionsNone.Measurements And Main ResultsLeukocyte counts were recorded during the first 4 days following sepsis diagnosis. Persistent lymphopenia was defined as an absolute lymphocyte count less than 1.2 cells/μL×10(3) present on the fourth day after diagnosis. Of the 445 patients with sepsis included, hypothermia developed in 64 patients (14.4%) (defined as a body temperature<36.0°C) within 24 hours of sepsis diagnosis. Hypothermia was a significant independent predictor of persistent lymphopenia (adjusted odds ratio, 2.70 [95% CI, 1.10, 6.60]; p=0.03) after accounting for age, disease severity, comorbidities, source of bacteremia, and type of organism. Compared with the nonhypothermic patients, hypothermic patients had higher 28-day (50.0% vs 24.9%, p<0.001) and 1-year mortality (60.9% vs 47.0%, p=0.001).ConclusionsHypothermia is associated with higher mortality and an increased risk of persistent lymphopenia in patients with sepsis, and it may be an early clinical predictor of sepsis-induced immunosuppression.

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