Globulinas totales y recuento linfocitario como marcadores de mortalidad en sepsis y shock séptico

Abstract

Background: There are no studies probing if patients in sepsis or septic shock with lower levels of total plasmatic globulins and/or lymphocyte count have higher mortality. Patients and Method: Prospective cohort study of 103 patients admitted in Intensive Care Unit followed daily at the Dr. Gustavo Fricke Hospital between June and November of 2009, with sepsis or septic shock criteria. Results: There was association between mortality and lymphocytic count measured from the third day of their hospitalization (P < 0.05), but not when compared with the plasmatic globulin measurements (P > 0.05). The area under ROC curve for the mean lymphocyte count at the third day was 0.68 (95% CI 0.53-0.82), with a sensitivity of 75%, specifi city of 52%, LR(+) 1.57 and LR(-) 0.48 for a cut-off at 510 lymphocytes/mm3, behaving also as an independent risk factor of mortality (OR 3.67, 95% CI 1.03-13.1). Discussion: Lymphocyte count is early and independently associated with increased mortality in patients with sepsis or septic shock.