Work

Dynamic alterations of lymphocyte subsets following sepsis in octogenarian and elder patients

Year: 2025

Type: article

Abstract: Background Sepsis is defined as a life-threatening organ dysfunction caused by dysregulated host responses to infections. This study aimed to investigate the early and dynamic changes in peripheral lymphocyte subsets following sepsis in octogenarian and old patients and whether these changes were related to 28-day mortality. Methods A prospective cohort study of 3601 consecutive patients admitted to the intensive care unit (ICU) was performed between March 2017 and January 2023. Peripheral blood samples were collected on admission, Day 3, and Day 7 for patients with sepsis and on enrollment for patients without sepsis. Lymphocyte subsets were detected by flow cytometry. The 28-day mortality was determined using Kaplan–Meier analysis, while Cox regression identified prognostic factors. Results All enrolled patients were divided into three groups: adult (18–64 years), old (65–79 years), and octogenarian (≥80 years). Sepsis induced a numerical reduction in lymphocytes (median=0.653 [IQR: 0.500–1.038] vs . median=0.840 [IQR: 0.579–1.142] × 10 9 /L, P =0.043) and CD3 + T-cell counts (median=0.461 [IQR: 0.312–0.759] vs . median=0.590 [IQR: 0.417–0.789] × 10 9 /L, P =0.021) in octogenarian patients. Kaplan–Meier survival curves showed that in the old ( P [log-rank test] < 0.001) and octogenarian ( P [log-rank test]=0.02) groups, patients with CD3 + T-cell nonrecovery on Day 3 and Day 7 had the highest mortality, followed by those with late recovery, and the lowest mortality was observed in the early recovery group. Multivariate Cox regression analysis demonstrated that age (hazard ratio [HR]=1.217, 95% confidence interval [CI]: 1.050 to 1.410, P =0.009) and CD3 + T-cell counts (HR=0.999, 95% CI: 0.999 to 1.000, P < 0.001) were independent risk factors associated with 28-day mortality in patients with sepsis. Conclusions Sepsis induced a numerical reduction in lymphocytes and CD3 + T-cell counts in octogenarian patients (≥80 years). The persistent decrease of CD3 + T-cell counts on Day 3 and Day 7 following sepsis was associated with higher mortality in old and octogenarian patients. Trial registration Chinese Clinical Trial Registry identifier: ChiCTR-ROC-17010750.

Source: Journal of Intensive Medicine

DOI: 10.1016/j.jointm.2025.04.002

Authors: Jiahui Zhang, Wei Cheng, Dongkai Li, Ran Guo, Guoyu Zhao, Na Cui

Institutions: Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Capital Medical University, Beijing Chao-Yang Hospital, Capital Medical University

Language: English

Topic: Sepsis Diagnosis and Treatment

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,100