ArticleShock (Augusta, Ga.)2014
Persistent lymphopenia after diagnosis of sepsis predicts mortality.
Article in Shock (Augusta, Ga.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 312 papers, 5 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
312 citing papers in PubMed, 5 syntheses or guidelines pooled it, 473 citations in OpenAlex.
- Peripheral adaptive immune cell counts and mortality in adult sepsis: a systematic review and meta-analysis.Frontiers in immunology · 2026Pooled it
- A bibliometric and visual analysis of research trends and hotspots in sepsis-related immunosuppression (2005-2025).Frontiers in pharmacology · 2026Pooled it
- Pooled prevalence of lymphopenia in all-cause hospitalisations and association with infection: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- Prognostic Value of Platelet to Lymphocyte Ratio in Sepsis: A Systematic Review and Meta-analysis.BioMed research international · 2022Pooled it
- Preoperative lymphopaenia, mortality, and morbidity after elective surgery: systematic review and meta-analysis.British journal of anaesthesia · 2021Pooled it
- A randomized, double-blind, placebo-controlled trial of IL-7 in critically ill patients with COVID-19.JCI insight · 2025Trial
- The impact of ulinastatin on lymphocyte apoptosis and autophagy in sepsis patients.Scientific reports · 2024Trial
- Therapeutic Hyperthermia Is Associated With Improved Survival in Afebrile Critically Ill Patients With Sepsis: A Pilot Randomized Trial.Critical care medicine · 2022Trial
- Persistent lymphopaenia in critically ill patients with and without sepsis: An Australian and New Zealand point prevalence study.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Longitudinal and adjusted prognostic assessment of calprotectin in Gram-negative sepsis with acute respiratory failure.Microbiology spectrum · 2026Observational
- Phenotype-based appropriateness of IGM-enriched polyclonal immunoglobulin use in critical illness: report of an expert consensus.Journal of anesthesia, analgesia and critical care · 2026Review
- Bacterial Pneumonia in Horses: Insights from a 10-Year European Single-Centre Retrospective Study.Veterinary sciences · 2026Article
- Early Immune Phenotype-Guided Immunomodulatory Strategies and Intensive Care Outcomes in Septic Shock: A Single-Center Retrospective Cohort Study.Shock (Augusta, Ga.) · 2026Observational
- Persistent inflammation, immunosuppression, and catabolism are associated with impaired lymphocytic mitochondrial metabolism during the early phase of sepsis. A single-center, prospective cohort study.Anaesthesiology intensive therapy · 2026Article
- Longitudinal immune-inflammatory profiles and mortality in older adults with sepsis: a multicentre prospective cohort study.Journal of intensive care · 2026Article
- Article
- Host-directed immune therapies: a second front in the battle against sepsis.The Journal of clinical investigation · 2026Review
- Prognostic Value of the C-Reactive Protein × Platelet-to-Lymphocyte Ratio for 28-Day Mortality in Patients With Sepsis: A Retrospective Cohort Study.Health science reports · 2026Article
- First-week absolute lymphocyte count dynamics and 28-day mortality in older adults with sepsis.BMC infectious diseases · 2026Article
- Age-related differences and common pathways of lymphocyte subsets in sepsis: a comparative review of elderly and pediatric patients.Cell death & disease · 2026Review
252 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveThe objective of this study was to determine whether persistent lymphopenia on the fourth day following the diagnosis of sepsis predicts mortality.
methodsThis was a single-center, retrospective cohort study of 335 adult patients with bacteremia and sepsis admitted to a large university-affiliated tertiary care hospital between January 1, 2010, and July 31, 2012. All complete blood cell count profiles during the first 4 days following the diagnosis of sepsis were recorded. The primary outcome was 28-day mortality. Secondary outcomes included development of secondary infections, 1-year mortality, and hospital and intensive care unit lengths of stay.
resultsSeventy-six patients (22.7%) died within 28 days. Lymphopenia was present in 28-day survivors (median, 0.7 × 10 cells/μL; interquartile range [IQR], 0.4-1.1 × 10 cells/μL) and nonsurvivors (median, 0.6 × 10 cells/μL; IQR, 0.4-1.1 × 10 cells/μL) at the onset of sepsis and was not significantly different between the groups (P = 0.35). By day 4, the median absolute lymphocyte count was significantly higher in survivors compared with nonsurvivors (1.1 × 10 cells/μL [IQR, 0.7-1.5 × 10 cells/μL] vs. 0.7 × 10 cells/μL [IQR, 0.5-1.0 × 10 cells/μL]; P < 0.0001). Using logistic regression to account for potentially confounding factors (including age, Acute Physiology and Chronic Health Evaluation II score, comorbidities, surgical procedure during the study period, and time until appropriate antibiotic administration), day 4 absolute lymphocyte count was found to be independently associated with 28-day survival (adjusted odds ratio, 0.68 [95% confidence interval, 0.51-0.91]) and 1-year survival (adjusted odds ratio, 0.74 [95% confidence interval, 0.59-0.93]). Severe persistent lymphopenia (defined as an absolute lymphocyte count of 0.6 × 10 cells/μL or less on the fourth day after sepsis diagnosis) was associated with increased development of secondary infections (P = 0.04).
conclusionsPersistent lymphopenia on the fourth day following the diagnosis of sepsis predicts early and late mortality and may serve as a biomarker for sepsis-induced immunosuppression.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.