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1996-02-27
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Document 0735
DOCN M9630735
TI Alterations in lymphocyte subsets as prognosticators of postoperative
infections.
DT 9603
AU Gennari R; Dominioni L; Imperatori A; Bianchi V; Maroni P; Dionigi R;
Department of Surgery, University of Pavia in Varese, Ospedale;
Multizonale, Italy.
SO Eur J Surg. 1995 Jul;161(7):493-9. Unique Identifier : AIDSLINE
MED/96026958
AB OBJECTIVE: To evaluate changes in lymphocyte subsets after major
abdominal and thoracic operations, and to correlate changes with the
development of clinically relevant infections postoperatively. DESIGN:
Open study. SETTING: University hospital, Italy. SUBJECTS: 33 patients
who were to undergo major abdominal or thoracic operations.
INTERVENTIONS: Lymphocyte subsets were measured by cytofluorimetry
before operation and 1, 3, 5, and 7 days postoperatively. MAIN OUTCOME
MEASURES: Correlation between changes in the number of lymphocyte
subsets and development of infection. RESULTS: Lymphocyte subsets were
within the reference range in all patients before operation. 10/33
Patients developed infections (pneumonia, bacteraemia, or wound or
urinary tract infections) between the second and the ninth days
postoperatively (30%). On day 1 the numbers of all lymphocyte subsets
had decreased significantly compared with the preoperative measurements
in all patients (CD3 p < 0.01, CD4 p < 0.001, and CD8 p < 0.05). The
reduction in CD3 was significantly greater in the group that developed
infections (p < 0.001). Among patients who did not develop infections
the numbers of lymphocyte subsets had returned to the reference range
within a week of operation whereas among patients who developed
infections they remained depressed (p < 0.05). CONCLUSION: The
synchronous reduction in numbers of all lymphocyte subsets on the first
day postoperatively to below 50% of the reference range (CD3 to <
600/microliters, CD4 to < 400/microliters, and CD8 to < 250/microliters)
predicted the development of infection postoperatively with an accuracy
of 89%, a sensitivity of 80%, and a specificity of 96%.
DE Adult Aged CD4 Lymphocyte Count Female Human
Infection/ETIOLOGY/*IMMUNOLOGY Lymphocyte Count Male Middle Age
Postoperative Complications/ETIOLOGY/*IMMUNOLOGY Prognosis Sensitivity
and Specificity Surgical Wound Infection/IMMUNOLOGY T-Lymphocyte
Subsets/*IMMUNOLOGY T-Lymphocytes/IMMUNOLOGY T-Lymphocytes,
Helper-Inducer/*IMMUNOLOGY T-Lymphocytes,
Suppressor-Effector/*IMMUNOLOGY CLINICAL TRIAL JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).