A leukocyte score to improve clinical outcome predictions in bacteremic pneumococcal pneumonia in adults

Open Forum Infectious Diseases
Mathieu BlotLionel Piroth

Abstract

Bacteremic pneumococcal pneumonia (BPP) is associated with high and early mortality. A simple procedure to predict mortality is crucial. All adult patients with BPP admitted from 2005 through 2013 to the University Hospital of Dijon, France, were enrolled to study 30-day mortality and associated factors, particularly leukocyte counts. A simple leukocyte score was created by adding 1 point each for neutropenia (<1500 cells/mm(3)), lymphopenia (<400), and monocytopenia (<200). One hundred and ninety-two adult patients (mean age, 69 years; standard deviation [SD], 19 years) who had developed and were hospitalized for BPP (58% community-acquired) were included. The 30-day crude mortality rate was 21%. The mean Pneumonia Severity Index score was high at 127.3 (SD = 41.3). Among the 182 patients who had a white blood cell count, 34 (19%) had a high leukocyte score (≥2). Multivariate analysis revealed that mortality was significantly associated with a high leukocyte score (odds ratio, 6.28; 95% confidence interval, 2.35-16.78), a high respiratory rate, a low serum bicarbonate level, and an altered mental status (all P < .05). The leukocyte score was not significantly dependent on the previous state of immunosuppression, alcoholism, or...Continue Reading

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Citations

Apr 14, 2015·Annals of Hematology·Maite Serrando i QuerolEsperanza Tuset Andujar
Sep 8, 2016·Journal of the American Medical Directors Association·Alain PutotPatrick Manckoundia
Jul 22, 2017·Open Forum Infectious Diseases·Julianna G GardnerDaniel M Musher
Aug 8, 2018·Scientific Reports·Mathieu BlotPierre-Emmanuel Charles
Apr 10, 2019·Médecine et maladies infectieuses·M BlotP E Charles

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