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Delayed hypersensitivity on a surgical service.

A Lefemine1, R Acuff, N Vo

  • 1Department of Surgery, Veterans Administration Medical Center, Johnson City, Tennessee 37684.

Journal of the American College of Nutrition
|October 1, 1988
PubMed
Summary
This summary is machine-generated.

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Nutritional deficiencies impact immune response. Patients with negative skin tests (anergic) faced higher mortality and sepsis rates, indicating impaired cell-mediated immunity.

Area of Science:

  • Immunology
  • Clinical Medicine
  • Nutritional Science

Background:

  • Nutritional deficiencies can impair immune function.
  • Cell-mediated immunity plays a crucial role in host defense.
  • Assessing immune status through skin testing is a common clinical practice.

Purpose of the Study:

  • To investigate the relationship between nutritional status, immune response via skin testing, and outcomes like sepsis and mortality.
  • To determine if impaired delayed hypersensitivity correlates with increased morbidity and mortality in a patient cohort.

Main Methods:

  • Analysis of 200 patients assessed for nutritional deficiencies.
  • Skin testing with common antigens (PPD, Candida, mumps).
  • Statistical analysis (Chi-square, Gamma) correlating skin test results with sepsis and mortality data.

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Main Results:

  • Only 39% of all skin tests were positive; 50% had at least one positive test.
  • Anergic patients (negative tests) showed a threefold higher mortality rate.
  • Major sepsis incidence increased by 80% in the anergic group, correlating with the number of positive tests.
  • Mortality was linked to the presence of delayed hypersensitivity, not the number of positive reactions.

Conclusions:

  • Impaired delayed hypersensitivity (anergy) is associated with significantly increased mortality in patients with nutritional deficiencies.
  • While sepsis incidence correlates with the number of positive skin tests, mortality is primarily influenced by the presence of delayed hypersensitivity.
  • Skin testing can be a valuable tool in assessing immune competence and predicting outcomes in nutritionally compromised patients.