Relationship between Cellular Immunity Changes and Prognosis in Elderly Patients with Sepsis

Area of Science:

• Immunology
• Geriatrics
• Critical Care Medicine

Background:

• Sepsis significantly impacts elderly populations, with cellular immunity playing a crucial role in patient outcomes.
• Understanding the relationship between immune status and prognosis is vital for managing sepsis in older adults.

Purpose of the Study:

• To investigate the association between changes in cellular immunity and the prognosis of sepsis in elderly patients.
• To identify predictors of 28-day re-hospitalization in sepsis patients.

Main Methods:

• An observational study involving 687 patients (350 sepsis, 337 non-sepsis) and 141 healthy controls.
• Comparison of T lymphocyte subsets (CD3+T, CD4+T, CD8+T, NK cells) and APACHE II scores between sepsis and non-sepsis groups, stratified by age.
• Statistical analysis of the 28-day re-hospitalization rate in relation to immune cell counts and APACHE II scores.

Main Results:

• Elderly patients and sepsis patients exhibited significantly lower levels of CD3+T, CD4+T, CD8+T, and NK cells compared to controls and non-sepsis groups.
• Sepsis patients, particularly the elderly, had higher APACHE II scores.
• The 28-day re-hospitalization rate was significantly associated with lower CD3+T, CD4+T, CD8+T cell counts and higher APACHE II scores.

Conclusions:

• Reduced CD3+T, CD4+T, and CD8+T lymphocyte subsets are observed in elderly sepsis patients.
• APACHE II scores and specific T lymphocyte subsets (CD3+T, CD4+T, CD8+T) are independent predictors of 28-day re-hospitalization in sepsis patients.