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Abstract
The prognostic significance of absolute lymphocyte count (ALC) and absolute neutrophil count (ANC) remains unclear in patients with postoperative pneumonia (POP). The study objectives were to investigate the prognostic effects of ALC and ANC in POP patients, and to evaluate the time courses of ALC and ANC during hospitalization. This post-hoc analysis of a single-center prospective observational study evaluated consecutive POP patients, and comparatively analyzed community-acquired pneumonia (CAP) patients to highlight features of POP. In total, 228 POP patients and 1027 CAP patients were assessed. Severe lymphopenia (ALC < 500 cells/μL) at diagnosis was associated with worse 90-day survival in both types of pneumonia. In POP patients, neutrophilia (ANC > 7500 cells/μL) was associated with better survival, whereas CAP patients with neutrophilia tended to have a lower survival rate. Prolonged lymphopenia and delayed increase in neutrophils were characteristic time-course changes of non-survivors in POP. The time courses of ALC and ANC between survivors and non-survivors in POP trended differently from those in CAP. Our study showed that ALC and ANC at pneumonia diagnosis can serve as prognostic factors in POP patients. Differences in time-course changes of ALC and ANC between survivors and non-survivors may provide important information for future immunological research in pneumonia.
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1 Nagoya University Graduate School of Medicine, Department of Respiratory Medicine, Nagoya, Japan (GRID:grid.27476.30) (ISNI:0000 0001 0943 978X)
2 Nagoya University Graduate School of Medicine, Department of Respiratory Medicine, Nagoya, Japan (GRID:grid.27476.30) (ISNI:0000 0001 0943 978X); National Hospital Organization Higashinagoya National Hospital, Department of Respiratory Medicine, Nagoya, Japan (GRID:grid.27476.30)
3 Nagoya University Graduate School of Medicine, Department of Respiratory Medicine, Nagoya, Japan (GRID:grid.27476.30) (ISNI:0000 0001 0943 978X); Toyota Memorial Hospital, Department of Respiratory Medicine, Toyota, Japan (GRID:grid.417248.c) (ISNI:0000 0004 1764 0768)
4 Nagoya University Hospital, Department of Infectious Diseases, Nagoya, Japan (GRID:grid.437848.4) (ISNI:0000 0004 0569 8970)
5 Nagoya University Graduate School of Medicine, Department of Biostatistics, Nagoya, Japan (GRID:grid.27476.30) (ISNI:0000 0001 0943 978X); Tokyo Medical and Dental University, Department of Biostatistics, M&D Data Science Center, Tokyo, Japan (GRID:grid.265073.5) (ISNI:0000 0001 1014 9130)
6 Nagoya University Graduate School of Medicine, Department of Biostatistics, Nagoya, Japan (GRID:grid.27476.30) (ISNI:0000 0001 0943 978X)
7 Nagoya University Graduate School of Medicine, Department of Respiratory Medicine, Nagoya, Japan (GRID:grid.27476.30) (ISNI:0000 0001 0943 978X); Nagoya Medical Center, National Hospital Organization, Nagoya, Japan (GRID:grid.410840.9) (ISNI:0000 0004 0378 7902)