Postoperative lymphopenia: An independent risk factor for postoperative pneumonia after lung cancer surgery, results of a case-control study
Postoperative lymphopenia has been proposed as a risk factor for postoperative infections but has never been identified as such in a multivariate analysis. Postoperative pneumonia (POP) is one of the most common complications after lung cancer surgery and is associated with a worse outcome. We aimed...
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| Veröffentlicht in: | PloS one 2018-10, Vol.13 (10), p.e0205237-e0205237 |
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| description | Postoperative lymphopenia has been proposed as a risk factor for postoperative infections but has never been identified as such in a multivariate analysis. Postoperative pneumonia (POP) is one of the most common complications after lung cancer surgery and is associated with a worse outcome. We aimed to evaluate the association between postoperative lymphopenia and POP after lung cancer surgery.
Patients admitted for lung cancer surgery (lobectomy, bilobectomy, or pneumonectomy) aged ≥ 18 years and with no history of an immunosuppressive state were eligible for inclusion. Lymphocyte counts were determined in blood drawn on the day before surgery and at postoperative days 1, 3 and 7. POP diagnosis was based on clinical, biological and radiological data. A logistic regression model adjusted on currently described risk factors for POP was used to explain the onset of this condition.
Two hundred patients were included, of whom 43 (21.5%) developed POP. Preoperative lymphocyte count was 1.8±0.6x10(9) cells/L and 2.0±0.7x10(9) cells/L in patients with and without POP, respectively (P = .091). In both groups, the lymphocyte count nadir occurred at postoperative day 1. In multivariate analysis, lymphopenia at postoperative day 1 was significantly associated with increased risk of POP (odds ratio: 2.63, 95% CI [1.03-5.40]). POP rate at postoperative day 7 was higher in patients presenting low lymphocyte counts (≤1.19x10(9) cells/L) at postoperative day 1 (P = .003).
Our study showed that lymphopenia following lung cancer surgery was maximal at postoperative day 1 and was associated with POP. |
| doi_str_mv | 10.1371/journal.pone.0205237 |
| format | Article |
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Patients admitted for lung cancer surgery (lobectomy, bilobectomy, or pneumonectomy) aged ≥ 18 years and with no history of an immunosuppressive state were eligible for inclusion. Lymphocyte counts were determined in blood drawn on the day before surgery and at postoperative days 1, 3 and 7. POP diagnosis was based on clinical, biological and radiological data. A logistic regression model adjusted on currently described risk factors for POP was used to explain the onset of this condition.
Two hundred patients were included, of whom 43 (21.5%) developed POP. Preoperative lymphocyte count was 1.8±0.6x10(9) cells/L and 2.0±0.7x10(9) cells/L in patients with and without POP, respectively (P = .091). In both groups, the lymphocyte count nadir occurred at postoperative day 1. In multivariate analysis, lymphopenia at postoperative day 1 was significantly associated with increased risk of POP (odds ratio: 2.63, 95% CI [1.03-5.40]). POP rate at postoperative day 7 was higher in patients presenting low lymphocyte counts (≤1.19x10(9) cells/L) at postoperative day 1 (P = .003).
Our study showed that lymphopenia following lung cancer surgery was maximal at postoperative day 1 and was associated with POP.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0205237</identifier><identifier>PMID: 30321194</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Anesthesia ; Antibiotics ; Bernard, Claude (1813-1878) ; Biology and Life Sciences ; Blood ; Cancer ; Cancer surgery ; Case-Control Studies ; Cell number ; Cholecystectomy ; Chronic obstructive pulmonary disease ; Complications ; Complications and side effects ; Female ; Health risks ; Hospitals ; Humans ; Immunosuppression ; Infections ; Laparoscopy ; Lobectomy ; Lung - surgery ; Lung cancer ; Lung diseases ; Lung Neoplasms - surgery ; Lymphocyte Count ; Lymphocytes ; Lymphocytopenia ; Lymphopenia ; Lymphopenia - blood ; Lymphopenia - epidemiology ; Lymphopenia - etiology ; Male ; Medicine and Health Sciences ; Middle Aged ; Multivariate analysis ; Odds Ratio ; Patients ; Pneumonectomy - adverse effects ; Pneumonectomy - methods ; Pneumonia ; Pneumonia - epidemiology ; Pneumonia - etiology ; Postoperative complications ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Postoperative Period ; Regression analysis ; Regression models ; Retrospective Studies ; Risk analysis ; Risk Factors ; Sepsis ; Surgery ; Thoracic surgery ; Trauma</subject><ispartof>PloS one, 2018-10, Vol.13 (10), p.e0205237-e0205237</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Dupont et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Dupont et al 2018 Dupont et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-15da458c1cb8ffb799e96067b930aaac3a67b33542f8983c06bd22ddc06d45c73</citedby><cites>FETCH-LOGICAL-c758t-15da458c1cb8ffb799e96067b930aaac3a67b33542f8983c06bd22ddc06d45c73</cites><orcidid>0000-0002-6499-8418</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188898/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188898/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30321194$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Ahmad, Aamir</contributor><creatorcontrib>Dupont, Guillaume</creatorcontrib><creatorcontrib>Flory, Laura</creatorcontrib><creatorcontrib>Morel, Jérôme</creatorcontrib><creatorcontrib>Lukaszewicz, Anne-Claire</creatorcontrib><creatorcontrib>Patoir, Arnaud</creatorcontrib><creatorcontrib>Presles, Emilie</creatorcontrib><creatorcontrib>Monneret, Guillaume</creatorcontrib><creatorcontrib>Molliex, Serge</creatorcontrib><title>Postoperative lymphopenia: An independent risk factor for postoperative pneumonia after lung cancer surgery, results of a case-control study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Postoperative lymphopenia has been proposed as a risk factor for postoperative infections but has never been identified as such in a multivariate analysis. Postoperative pneumonia (POP) is one of the most common complications after lung cancer surgery and is associated with a worse outcome. We aimed to evaluate the association between postoperative lymphopenia and POP after lung cancer surgery.
Patients admitted for lung cancer surgery (lobectomy, bilobectomy, or pneumonectomy) aged ≥ 18 years and with no history of an immunosuppressive state were eligible for inclusion. Lymphocyte counts were determined in blood drawn on the day before surgery and at postoperative days 1, 3 and 7. POP diagnosis was based on clinical, biological and radiological data. A logistic regression model adjusted on currently described risk factors for POP was used to explain the onset of this condition.
Two hundred patients were included, of whom 43 (21.5%) developed POP. Preoperative lymphocyte count was 1.8±0.6x10(9) cells/L and 2.0±0.7x10(9) cells/L in patients with and without POP, respectively (P = .091). In both groups, the lymphocyte count nadir occurred at postoperative day 1. In multivariate analysis, lymphopenia at postoperative day 1 was significantly associated with increased risk of POP (odds ratio: 2.63, 95% CI [1.03-5.40]). POP rate at postoperative day 7 was higher in patients presenting low lymphocyte counts (≤1.19x10(9) cells/L) at postoperative day 1 (P = .003).
Our study showed that lymphopenia following lung cancer surgery was maximal at postoperative day 1 and was associated with POP.</description><subject>Aged</subject><subject>Anesthesia</subject><subject>Antibiotics</subject><subject>Bernard, Claude (1813-1878)</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Cancer</subject><subject>Cancer surgery</subject><subject>Case-Control Studies</subject><subject>Cell number</subject><subject>Cholecystectomy</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Complications</subject><subject>Complications and side effects</subject><subject>Female</subject><subject>Health risks</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunosuppression</subject><subject>Infections</subject><subject>Laparoscopy</subject><subject>Lobectomy</subject><subject>Lung - surgery</subject><subject>Lung cancer</subject><subject>Lung diseases</subject><subject>Lung Neoplasms - surgery</subject><subject>Lymphocyte Count</subject><subject>Lymphocytes</subject><subject>Lymphocytopenia</subject><subject>Lymphopenia</subject><subject>Lymphopenia - blood</subject><subject>Lymphopenia - epidemiology</subject><subject>Lymphopenia - etiology</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Odds Ratio</subject><subject>Patients</subject><subject>Pneumonectomy - adverse effects</subject><subject>Pneumonectomy - methods</subject><subject>Pneumonia</subject><subject>Pneumonia - epidemiology</subject><subject>Pneumonia - etiology</subject><subject>Postoperative complications</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Period</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Sepsis</subject><subject>Surgery</subject><subject>Thoracic 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lymphopenia: An independent risk factor for postoperative pneumonia after lung cancer surgery, results of a case-control study</title><author>Dupont, Guillaume ; Flory, Laura ; Morel, Jérôme ; Lukaszewicz, Anne-Claire ; Patoir, Arnaud ; Presles, Emilie ; Monneret, Guillaume ; Molliex, Serge</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-15da458c1cb8ffb799e96067b930aaac3a67b33542f8983c06bd22ddc06d45c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Anesthesia</topic><topic>Antibiotics</topic><topic>Bernard, Claude (1813-1878)</topic><topic>Biology and Life Sciences</topic><topic>Blood</topic><topic>Cancer</topic><topic>Cancer surgery</topic><topic>Case-Control Studies</topic><topic>Cell number</topic><topic>Cholecystectomy</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Complications</topic><topic>Complications and side 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pneumonia after lung cancer surgery, results of a case-control study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-10-15</date><risdate>2018</risdate><volume>13</volume><issue>10</issue><spage>e0205237</spage><epage>e0205237</epage><pages>e0205237-e0205237</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Postoperative lymphopenia has been proposed as a risk factor for postoperative infections but has never been identified as such in a multivariate analysis. Postoperative pneumonia (POP) is one of the most common complications after lung cancer surgery and is associated with a worse outcome. We aimed to evaluate the association between postoperative lymphopenia and POP after lung cancer surgery.
Patients admitted for lung cancer surgery (lobectomy, bilobectomy, or pneumonectomy) aged ≥ 18 years and with no history of an immunosuppressive state were eligible for inclusion. Lymphocyte counts were determined in blood drawn on the day before surgery and at postoperative days 1, 3 and 7. POP diagnosis was based on clinical, biological and radiological data. A logistic regression model adjusted on currently described risk factors for POP was used to explain the onset of this condition.
Two hundred patients were included, of whom 43 (21.5%) developed POP. Preoperative lymphocyte count was 1.8±0.6x10(9) cells/L and 2.0±0.7x10(9) cells/L in patients with and without POP, respectively (P = .091). In both groups, the lymphocyte count nadir occurred at postoperative day 1. In multivariate analysis, lymphopenia at postoperative day 1 was significantly associated with increased risk of POP (odds ratio: 2.63, 95% CI [1.03-5.40]). POP rate at postoperative day 7 was higher in patients presenting low lymphocyte counts (≤1.19x10(9) cells/L) at postoperative day 1 (P = .003).
Our study showed that lymphopenia following lung cancer surgery was maximal at postoperative day 1 and was associated with POP.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30321194</pmid><doi>10.1371/journal.pone.0205237</doi><tpages>e0205237</tpages><orcidid>https://orcid.org/0000-0002-6499-8418</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_2120170209 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Aged Anesthesia Antibiotics Bernard, Claude (1813-1878) Biology and Life Sciences Blood Cancer Cancer surgery Case-Control Studies Cell number Cholecystectomy Chronic obstructive pulmonary disease Complications Complications and side effects Female Health risks Hospitals Humans Immunosuppression Infections Laparoscopy Lobectomy Lung - surgery Lung cancer Lung diseases Lung Neoplasms - surgery Lymphocyte Count Lymphocytes Lymphocytopenia Lymphopenia Lymphopenia - blood Lymphopenia - epidemiology Lymphopenia - etiology Male Medicine and Health Sciences Middle Aged Multivariate analysis Odds Ratio Patients Pneumonectomy - adverse effects Pneumonectomy - methods Pneumonia Pneumonia - epidemiology Pneumonia - etiology Postoperative complications Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Period Regression analysis Regression models Retrospective Studies Risk analysis Risk Factors Sepsis Surgery Thoracic surgery Trauma |
| title | Postoperative lymphopenia: An independent risk factor for postoperative pneumonia after lung cancer surgery, results of a case-control study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T09%3A34%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Postoperative%20lymphopenia:%20An%20independent%20risk%20factor%20for%20postoperative%20pneumonia%20after%20lung%20cancer%20surgery,%20results%20of%20a%20case-control%20study&rft.jtitle=PloS%20one&rft.au=Dupont,%20Guillaume&rft.date=2018-10-15&rft.volume=13&rft.issue=10&rft.spage=e0205237&rft.epage=e0205237&rft.pages=e0205237-e0205237&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0205237&rft_dat=%3Cgale_plos_%3EA559617750%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2120170209&rft_id=info:pmid/30321194&rft_galeid=A559617750&rft_doaj_id=oai_doaj_org_article_084adc58e16d491eb1d684ba845ae21a&rfr_iscdi=true |