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Prognostic significance of the neutrophil count in immunocompetent patients with bacteraemia

机译:中性粒细胞计数在具有免疫能力的菌血症患者中的预后意义

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To examine the prevalence of neutropaenia in immunocompetent, bacteraemic patients, and whether it carries an independent risk for mortality, we surveyed 2096 bacteraemic patients without malignant diseases, and who were not receiving cytotoxic drugs. The granulocyte count on the day of the first positive blood culture was < 1 x 10~9 cells/l in 33 patients (1.7%, group 1); 1.0-4.0 x 10~9 cells/l in 154 patients (7.9%, group 2); 4.0-8.0 x 10~9 cells/l in 564 patients (29%, group 3); 8.0-20.0 x 10~9 cells/l in 1034 patients (53%, group 4); and > 20.0 x 10~9 cells/l in 163 patients (8.4%, group 5). The mortality rates in the five groups were 39.4%, 18.8%, 18.1%, 25.7% and 25.8%, respectively (p = 0.0001). The main patho- gens in group 1 were Staphylococcus aureus in 25% of patients and Pseudomonas sp. in 23%. Mortality in group 1 patients was higher than in the other patients (odds ratio 1.4, 95% Cl 1.1-1.9], Mortality was also significantly higher in group 2 patients with high blood urea nitrogen. The percentage of neutro-paenic, septic patients without known risk factors for neutropaenia is small, but their mortality is high. Overall mortality in patients with relative neutropaenia (1.0-4.0 x 10~9 cells/l) is low, but a subgroup of patients with high blood urea nitrogen is at considerable risk for a fatal outcome. High leucocyte counts are also a marker of increased risk for mortality, but this association is not an independent prognostic factor.
机译:为了检查中性粒细胞减少症在有免疫能力的细菌性患者中的流行以及是否具有独立的死亡风险,我们调查了2096名无恶性疾病且未接受细胞毒性药物的细菌性患者。初次阳性血液培养当天的粒细胞计数<1 x 10〜9细胞/ l,共33例(1.7%,第1组); 154例患者中1.0-4.0 x 10〜9个细胞/升(7.9%,第2组); 564例患者中4.0-8.0 x 10〜9个细胞/升(29%,第3组); 1034例患者中8.0-20.0 x 10〜9个细胞/ l(53%,第4组); 163例患者中> 20.0 x 10〜9个细胞/l(8.4%,第5组)。五组的死亡率分别为39.4%,18.8%,18.1%,25.7%和25.8%(p = 0.0001)。第1组的主要病原是25%的患者中的金黄色葡萄球菌和假单胞菌。在23%。第1组患者的死亡率高于其他患者(几率1.4,95%Cl 1.1-1.9),第2组高尿素氮患者的死亡率也显着更高。已知的中性粒细胞减少症的危险因素虽小,但其死亡率却很高;相对中性粒细胞减少症(1.0-4.0 x 10〜9细胞/ l)的总死亡率较低,但一部分血尿素氮高的患者处于相当大的危险中高白细胞计数也是增加死亡风险的标志,但是这种关联并不是独立的预后因素。

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