Peripheral monocytosis as a predictive factor for adverse outcome in the emergency department: Survey based on a register study.

Détails

Ressource 1Télécharger: 28700476_BIB_96991DACB22B.pdf (198.04 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY-ND 4.0
ID Serval
serval:BIB_96991DACB22B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Peripheral monocytosis as a predictive factor for adverse outcome in the emergency department: Survey based on a register study.
Périodique
Medicine
Auteur⸱e⸱s
Hensel M., Grädel L., Kutz A., Haubitz S., Huber A., Mueller B., Schuetz P., Hügle T.
ISSN
1536-5964 (Electronic)
ISSN-L
0025-7974
Statut éditorial
Publié
Date de publication
07/2017
Peer-reviewed
Oui
Volume
96
Numéro
28
Pages
e7404
Langue
anglais
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Résumé
Monocytosis is associated with chronic infections such as tuberculosis or endocarditis as well as rheumatic and myeloproliferative disorders. Monocytes are also involved in the pathogenesis of atherosclerosis, coronary artery disease, and stroke. The value of monocytosis as a prognostic marker in different diagnostic groups in the emergency setting, however, has not been investigated so far.The aim of the article is to study monocytosis as an outcome factor in the emergency setting.In a Swiss register study, we analyzed monocyte counts in 4238 patients aged >18 years who were admitted to the emergency department of a regional tertiary care hospital. Monocytosis was defined as 0.8×10 cells/L. Diagnoses were grouped into infection, cardiovascular, neurological, metabolic, gastrointestinal, pulmonary, or other. Thirty-day mortality was defined as the primary endpointA total of 1217 patients with monocytosis were identified. Patients with monocytosis at admission suffered more frequently from respiratory symptoms (17.7% vs 8.9%, P <.001) and infection as the final diagnosis (20.8% vs 10.3%, P <.001) while neurological diagnoses were significantly lower in the monocytosis group (15.3% vs 30.9%, P <.001). Patients with monocytosis suffered from more comorbidities such as congestive heart failure, chronic obstructive pulmonary disease, tumor, diabetes, or renal failure but not dementia. When adjusted for age, gender, comorbidities, and main diagnosis, the 30-day mortality (P = .002) and length of stay (P = .001) were significantly higher in patients with monocytosis. The 30-day mortality in patients with monocytosis was most notably influenced by a cardiological diagnosis (odds ratio 3.91).An increased monocyte count predicts adverse outcome in patients admitted to the emergency department. Mechanistic studies will be necessary to specify the potentially detrimental role of monocytosis in critical illness.

Mots-clé
Adult, Aged, Comorbidity, Emergency Service, Hospital, Female, Humans, Length of Stay, Leukocyte Count, Leukocytosis/diagnosis, Male, Middle Aged, Monocytes, Mortality, Patient Readmission, Prognosis, Prospective Studies, Quality Control, Registries, Surveys and Questionnaires, Switzerland
Pubmed
Web of science
Open Access
Oui
Création de la notice
07/12/2017 13:22
Dernière modification de la notice
21/08/2019 7:09
Données d'usage