Objective: To detect relationship between cellular immunity changes and prognosis in elderly patients with sepsis.
Study Design: An observational study.
Place And Duration Of Study: General Department and Emergency Care Unit, Beijing Chaoyang Hospital, Beijing, China, from January to December 2016.
Methodology: Patients who had infection were included in this study, and divided into two groups; those with sepsis and no sepsis. One hundred and forty-one healthy volunteers were chosen to enroll in this study just as a control (control group). Patients were excluded if they were younger than 18 years of age; had hematological or immunological disease; had uncontrolled diabetes; and pretreated with immunosuppressive agents. Patients were further grouped according to age, their T lymphocyte subsets were compared, and their acute physiology and chronic health evaluation II (APACHE II) scores were compared. The 28-day re-hospitalisation rate was followed-up, and the effects of T lymphocyte subsets and APACHE II scores on this rate were statistical analysed.
Results: Out of the 687 patients, 350 patients had sepsis (sepsis group), and 337 patients had no sepsis (non-sepsis group). The age of these patients ranged from 19-96 years. CD3+T, CD4+T, CD8+T and natural NK cells were significantly lower in the elderly population, (p< 0.01). CD3+T, CD4+T, CD8+T and NK cells were significantly lower in the sepsis group, compared with patients in the non-sepsis group and control group; and the differences were statistically significant (p<0.05), while APACHE II score was significantly higher (p<0.01). In the sepsis group, compared with the non-elderly population, CD3+T, CD4+T and NK cells were significantly lower in the elderly population; and the differences were statistically significant (p<0.05), while APACHE II score was significantly higher (p<0.05). The 28-day re-hospitalisation rate was associated with CD3+T, CD4+T, CD8+T cells and APACHE II scores (p<0.05).
Conclusion: CD3+T, CD4+T, CD8+T cells and APACHE II scores can be used as independent predictors of the 28-day re-hospitalisation rate.
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