This study was performed to evaluate the association of monocyte counts with mortality, the rate of bacteremia, and organ dysfunction and to evaluate whether the change in monocyte counts from the premorbid state to sepsis would differ between survivors and non-survivors in patients with severe sepsis including septic shock. A retrospective analysis of patients with severe sepsis including septic shock was performed. Monocyte counts were categorized into <250, 250–500, 500–750, and ≥750 cells/μL; in addition, 28-day mortality, the rate of bacteremia, and organ dysfunction were compared between the groups. Multivariate logistic regression analyses were performed to evaluate the independent association of initial blood cell counts with 28-day mortality. Subgroup analyses of patients who had premorbid data of blood cell counts were performed to evaluate the difference in the change in monocyte counts between survivors and non-survivors. During the study period, 2,012 patients were included. Neutrophil and monocyte counts were significantly different between survivors and non-survivors. However, only monocyte counts were independently associated with mortality in the multivariate logistic regression analyses. Patients with initial monocyte counts <250 cells/μL showed the highest mortality, rate of bacteremia, and organ dysfunction. In patients who had premorbid blood cell counts, the monocyte counts increased in survivors but decreased in non-survivors from the premorbid to sepsis. In conclusion, monocyte counts were associated with mortality, the rate of bacteremia, and organ dysfunction in patients with sepsis, possibly due to the relative lack of monocytopoiesis related to septic insults in non-survivors.
*Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea
†Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, South Korea
Address reprint requests to You Hwan Jo, MD, PhD, Department of Emergency Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea; E-mail: email@example.com, firstname.lastname@example.org
Received 2 April, 2018
Revised 16 April, 2018
Accepted 19 May, 2018
HC and JHL equally contributed as first author.
Author Contributions: Conception and design was done by JHL and YHJ. Acquisition of data was carried out by HC, JHL, JEH, and JK. Analysis and interpretation was done by HC, JHL, and YHJ. Drafting the article for important intellectual content was carried out by HC, JHL, and YHJ.
This work was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT and Future Planning (NRF-2015R1C1A1A02037218) and the SNUBH research fund (Grant No. 14-2017-016).
The authors report no conflicts of interest.
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