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A descriptive study of immune status in patients undergoing colorectal surgery: lymphocyte phenotypes
A W Tax1, A J Orsi, M Lafferty
1Center for Advancing Care in Serious Illness, University of Pennsylvania School of Nursing, Philadelphia.
Purpose/Objectives:
To describe immune status in patients prior to colorectal surgery for cancer, to establish values to serve as a baseline for subsequent analyses, and to describe a procedure for studying phenotypes of the immune system, elucidating its advantages.
Design:
One component of a larger longitudinal survey.
Setting:
Two large, inner-city university hospitals and two of their affiliated hospitals in the northeastern United States.
Sample:
Patients undergoing surgery for colorectal cancer (N = 94). Subjects were primarily male (n = 57) and Caucasian (n = 85) and ranged in age from 26-88 years (mean = 63). Seventy-seven percent (n = 73) had cancer, 23% (n = 21) had benign diseases or conditions.
Methods:
Flow cytometry analysis of lymphocyte phenotypes was performed on blood samples drawn from patients before they underwent surgery for colorectal cancer.
Main Outcome Measures:
The average absolute lymphocyte subset levels and the average relative lymphocyte subset levels of blood samples taken from patients undergoing surgery for colorectal cancer were compared (using t-tests) with the subset levels of two normal reference samples.
Findings:
The average absolute lymphocyte subset levels and average relative lymphocyte subset levels of patients undergoing surgery for colorectal cancer fell within normal ranges.
Conclusions:
These findings suggest that this sample of patients undergoing surgery has one essential element of an intact immune system--normal levels of lymphocyte subsets.
Implications For Nursing Practice:
There is no indication preoperatively that this population is at a higher risk for infection or delayed wound healing. However, there may be other times in the illness trajectory when the immune system does become compromised, and these values prior to surgery will serve as a baseline to identify changes in patients' immune status over time. Further longitudinal studies are necessary.