Predictive Value of Lymphocyte Subsets for Nonviral Infection-Induced Early Sepsis in Adults

Although incidence and mortality vary widely among regions, sepsis remains a major cause of morbidity and cost worldwide. This study was conducted retrospectively to investigate the early indicative and predictive values of lymphocyte subsets in patients with sepsis.

A total of 106 patients with sepsis and 22 patients without sepsis were enrolled in the study. Peripheral blood samples were collected from all patients after admission to the intensive care unit. Absolute counts of lymphocyte subsets were performed by flow cytometry.

In comparison to nonseptic patients, septic patients had similar numbers of total lymphocytes, T, Th, and NK cells, but significantly increased absolute numbers of B cells ( P  = 0.02). Compared to survivors, absolute numbers of total lymphocytes, B cells and CTL cells were significantly decreased in nonsurvivors ( P  < 0.05 respectively). To evaluate the predictive efficiency for 30-day mortality risk, receiver operating characteristic curves were plotted and showed favorable predictive values for total lymphocytes (area under the curve [AUC] = 0.69, P  < 0.01), T cells (AUC = 0.66, P  = 0.02), B cells (AUC = 0.66, P  = 0.02), CTL cells (AUC = 0.65, P  = 0.04), and NK (AUC = 0.64, P  = 0.04), although they were not superior to Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II scores, Sequential Organ Failure Assessment (AUC = 0.70, P  < 0.01), and Acute Physiology and Chronic Health Evaluation II (AUC = 0.72, P  < 0.01), respectively.

Lymphocyte subsets are valuable indices of disease severity and predictive indicators of mortality in patients with sepsis. Optimal measures to restore lymphocyte subsets and immune function are imperative to improve the outcomes of patients with sepsis.